Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $60.26 / $165.96	Facility		$20.89	$60.26	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $29.51 / $134.90	Professional		$15.85	$29.51	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $39.81 / $50.12	Professional		$25.70	$39.81	$50.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $51.29 / $83.18	Professional		$20.89	$51.29	$83.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $32.36 / $70.79	Facility		$20.89	$32.36	$70.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $23.44 / $54.95	Professional		$12.59	$23.44	$54.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.70 / $26.92	Professional		$25.12	$25.70	$26.92
Midlands Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $25.70	Facility		$25.70	$25.70	$25.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
United Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $20.89 / $45.71	Facility		$20.89	$20.89	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $17.38 / $50.12	Professional		$12.59	$17.38	$50.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $20.89 / $20.89	Professional		$16.60	$20.89	$20.89