Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.11 / $43.02 / $123.57	Facility		$24.11	$43.02	$123.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.91 / $18.55 / $155.03	Professional		$15.91	$18.55	$155.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.08 / $44.39 / $55.49	Professional		$28.08	$44.39	$55.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $24.11 / $42.19 / $61.88	Professional		$24.11	$42.19	$61.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.11 / $31.11 / $87.34	Facility		$24.11	$31.11	$87.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.47 / $24.11 / $52.84	Professional		$14.47	$24.11	$52.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $22.12 / $44.21 / $64.73	Facility		$22.12	$44.21	$64.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $27.30 / $43.40 / $62.93	Professional		$27.30	$43.40	$62.93
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,156.43 / $3,034.81 / $5,241.93	Facility		$1,156.43	$3,034.81	$5,241.93
United Facility/Professional Professional Modifier Low / Median / High Price $14.47 / $15.34 / $50.43	Professional		$14.47	$15.34	$50.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $24.11 / $24.11	Professional		$19.05	$24.11	$24.11