Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $75.86 / $97.72	Facility		$28.18	$75.86	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $28.84 / $41.69	Professional		$22.91	$28.84	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $57.54 / $72.44	Professional		$34.67	$57.54	$72.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $19.95 / $169.82	Professional		$10.96	$19.95	$169.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $40.74 / $380.19	Facility		$24.55	$40.74	$380.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $23.99 / $257.04	Professional		$12.59	$23.99	$257.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $91.20	Professional		$56.23	$56.23	$91.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $56.23	Professional		$46.77	$46.77	$56.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $288.40 / $338.84	Professional		$251.19	$288.40	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $389.05 / $524.81	Facility		$223.87	$389.05	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $23.44 / $39.81	Professional		$12.59	$23.44	$39.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $21.38 / $25.12	Professional		$16.98	$21.38	$25.12