Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $50.12 / $199.53	Facility		$12.30	$50.12	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6.17 / $16.60 / $66.07	Professional		$6.17	$16.60	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $15.85 / $19.95	Professional		$11.75	$15.85	$19.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $14.45 / $46.77	Professional		$8.13	$14.45	$46.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $16.60 / $60.26	Facility		$8.13	$16.60	$60.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $4.79 / $8.32 / $20.89	Professional		$4.79	$8.32	$20.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $10.00	Professional		$10.00	$10.00	$10.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $10.00 / $10.00	Facility		$10.00	$10.00	$10.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $4,073.80 / $11,220.18	Facility		$1,023.29	$4,073.80	$11,220.18
United Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $8.13 / $17.78	Facility		$8.13	$8.13	$17.78
United Facility/Professional Professional Modifier Low / Median / High Price $4.79 / $6.03 / $19.50	Professional		$4.79	$6.03	$19.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $8.13 / $8.13	Professional		$6.31	$8.13	$8.13