Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $67.61 / $165.96	Facility		$31.62	$67.61	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $33.11 / $158.49	Professional		$15.85	$33.11	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $51.29	Professional		$26.92	$41.69	$51.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $38.90 / $128.82	Professional		$21.88	$38.90	$128.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $33.11 / $91.20	Facility		$21.88	$33.11	$91.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $26.30 / $56.23	Professional		$13.18	$26.30	$56.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.92 / $28.18	Professional		$26.30	$26.92	$28.18
Midlands Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $26.92	Facility		$26.92	$26.92	$26.92
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $47.86	Facility		$21.88	$21.88	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $18.20 / $52.48	Professional		$13.18	$18.20	$52.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $21.88 / $21.88	Professional		$16.98	$21.88	$21.88