Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $45.71 / $158.49	Facility		$25.12	$45.71	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $22.91 / $134.90	Professional		$18.20	$22.91	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $47.86 / $58.88	Professional		$35.48	$47.86	$58.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $61.66 / $151.36	Professional		$25.12	$61.66	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $32.36 / $77.62	Facility		$25.12	$32.36	$77.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $30.20 / $64.57	Professional		$15.14	$30.20	$64.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.90	Professional		$30.20	$30.20	$30.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Facility		$30.90	$30.90	$30.90
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
United Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $54.95	Facility		$25.12	$25.12	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $20.42 / $60.26	Professional		$15.14	$20.42	$60.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $25.12 / $25.12	Professional		$19.50	$25.12	$25.12