Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $69.18 / $398.11	Facility		$25.70	$69.18	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $95.50 / $446.68	Professional		$19.05	$95.50	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $48.98 / $61.66	Professional		$30.90	$48.98	$61.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $61.66 / $128.82	Professional		$25.70	$61.66	$128.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $38.90 / $79.43	Facility		$25.70	$38.90	$79.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $26.30 / $66.07	Professional		$15.14	$26.30	$66.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $33.11	Professional		$30.90	$30.90	$33.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Facility		$30.90	$30.90	$30.90
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Facility		$436.52	$436.52	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $56.23	Facility		$25.70	$25.70	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $21.38 / $61.66	Professional		$15.14	$21.38	$61.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.70 / $25.70	Professional		$19.95	$25.70	$25.70