Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.22 / $70.79 / $99.02	Facility		$39.22	$70.79	$99.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.10 / $28.02 / $42.05	Professional		$24.10	$28.02	$42.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.45 / $54.84 / $68.54	Professional		$34.45	$54.84	$68.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $10.79 / $16.30 / $169.28	Professional		$10.79	$16.30	$169.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.04 / $35.79 / $248.32	Facility		$27.04	$35.79	$248.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.61 / $23.18 / $258.24	Professional		$12.61	$23.18	$258.24
Midlands Facility/Professional Facility Modifier Low / Median / High Price $34.15 / $49.00 / $90.70	Facility		$34.15	$49.00	$90.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $55.81 / $94.92	Professional		$34.15	$55.81	$94.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.50 / $264.52 / $286.30	Professional		$40.50	$264.52	$286.30
United Facility/Professional Facility Modifier Low / Median / High Price $220.81 / $361.30 / $515.04	Facility		$220.81	$361.30	$515.04
United Facility/Professional Professional Modifier Low / Median / High Price $12.61 / $23.18 / $39.79	Professional		$12.61	$23.18	$39.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $21.30 / $25.10	Professional		$16.82	$21.30	$25.10