Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.02 / $85.71 / $177.61	Facility		$22.02	$85.71	$177.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.59 / $26.94 / $123.90	Professional		$11.59	$26.94	$123.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.35 / $27.42 / $34.27	Professional		$17.35	$27.42	$34.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $15.05 / $26.34 / $56.32	Professional		$15.05	$26.34	$56.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.05 / $30.37 / $108.03	Facility		$15.05	$30.37	$108.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.05 / $21.03 / $39.28	Professional		$15.05	$21.03	$39.28
Midlands Facility/Professional Facility Modifier Low / Median / High Price $18.44 / $30.67 / $47.18	Facility		$18.44	$30.67	$47.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $18.07 / $30.67 / $43.13	Professional		$18.07	$30.67	$43.13
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $262.42 / $1,111.28 / $1,919.48	Facility		$262.42	$1,111.28	$1,919.48
United Facility/Professional Professional Modifier Low / Median / High Price $15.05 / $15.05 / $34.46	Professional		$15.05	$15.05	$34.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $11.89 / $15.05 / $15.05	Professional		$11.89	$15.05	$15.05