Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.00 / $38.43 / $123.57	Facility		$12.00	$38.43	$123.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.04 / $15.21 / $53.39	Professional		$13.04	$15.21	$53.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.72 / $35.90 / $44.88	Professional		$22.72	$35.90	$44.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $19.75 / $34.56 / $56.83	Professional		$19.75	$34.56	$56.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.75 / $30.28 / $87.34	Facility		$19.75	$30.28	$87.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.85 / $20.05 / $50.43	Professional		$11.85	$20.05	$50.43
Midlands Facility/Professional Facility Modifier Low / Median / High Price $22.12 / $36.78 / $61.92	Facility		$22.12	$36.78	$61.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $23.70 / $36.78 / $51.72	Professional		$23.70	$36.78	$51.72
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $210.16 / $1,077.63 / $1,861.35	Facility		$210.16	$1,077.63	$1,861.35
United Facility/Professional Facility Modifier Low / Median / High Price $29.63 / $29.63 / $29.63	Facility		$29.63	$29.63	$29.63
United Facility/Professional Professional Modifier Low / Median / High Price $11.85 / $12.04 / $45.43	Professional		$11.85	$12.04	$45.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $15.60 / $19.75 / $19.75	Professional		$15.60	$19.75	$19.75