Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $41.69 / $57.54	Facility		$15.14	$41.69	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $16.98 / $30.90	Professional		$14.13	$16.98	$30.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $38.90 / $47.86	Professional		$23.99	$38.90	$47.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $48.98 / $72.44	Professional		$19.95	$48.98	$72.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $28.18 / $69.18	Facility		$19.95	$28.18	$69.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $25.70 / $107.15	Professional		$12.02	$25.70	$107.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $24.55 / $25.70	Professional		$23.99	$24.55	$25.70
Midlands Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Facility		$24.55	$24.55	$24.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $21.88 / $42.66	Professional		$19.95	$21.88	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $44.67	Facility		$19.95	$19.95	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $14.13 / $51.29	Professional		$12.02	$14.13	$51.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95