Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $112.20 / $501.19	Facility		$25.70	$112.20	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $95.50 / $478.63	Professional		$19.05	$95.50	$478.63
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 / $45.71 / $117.49	Professional		$25.70	$45.71	$117.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $35.48 / $79.43	Facility		$25.70	$35.48	$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 $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
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