Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.43 / $56.61 / $146.31	Facility		$30.43	$56.61	$146.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.02 / $27.37 / $130.47	Professional		$16.02	$27.37	$130.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.95 / $37.86 / $47.33	Professional		$23.95	$37.86	$47.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $20.81 / $36.42 / $108.92	Professional		$20.81	$36.42	$108.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.81 / $35.47 / $100.00	Facility		$20.81	$35.47	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $20.81 / $54.31	Professional		$12.49	$20.81	$54.31
Midlands Facility/Professional Facility Modifier Low / Median / High Price $25.49 / $42.42 / $65.23	Facility		$25.49	$42.42	$65.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $24.99 / $42.42 / $59.62	Professional		$24.99	$42.42	$59.62
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $198.64 / $198.64 / $198.64	Facility		$198.64	$198.64	$198.64
United Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $17.44 / $52.63	Professional		$12.49	$17.44	$52.63
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $16.44 / $20.81 / $20.81	Professional		$16.44	$20.81	$20.81