Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $54.95 / $194.98	Facility		$26.92	$54.95	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $26.92 / $89.13	Professional		$16.98	$26.92	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $66.07	Professional		$33.11	$52.48	$66.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $66.07 / $117.49	Professional		$26.92	$66.07	$117.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $34.67 / $85.11	Facility		$26.92	$34.67	$85.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $28.18 / $70.79	Professional		$16.22	$28.18	$70.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $34.67	Professional		$32.36	$33.11	$34.67
Midlands Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $33.11	Facility		$33.11	$33.11	$33.11
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $1,258.93 / $1,698.24	Facility		$309.03	$1,258.93	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $60.26	Facility		$26.92	$26.92	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $22.91 / $66.07	Professional		$16.22	$22.91	$66.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.92 / $26.92	Professional		$21.38	$26.92	$26.92