Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.49 / $118.89 / $150.35	Facility		$35.49	$118.89	$150.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.52 / $19.79 / $31.24	Professional		$17.52	$19.79	$31.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.30 / $41.13 / $51.41	Professional		$27.30	$41.13	$51.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $22.75 / $41.18 / $78.30	Professional		$22.75	$41.18	$78.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.75 / $31.85 / $71.31	Facility		$22.75	$31.85	$71.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.65 / $27.30 / $106.19	Professional		$13.65	$27.30	$106.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $41.72 / $71.31	Facility		$27.30	$41.72	$71.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $27.30 / $43.91 / $59.38	Professional		$27.30	$43.91	$59.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.14 / $26.62 / $46.41	Professional		$22.14	$26.62	$46.41
United Facility/Professional Facility Modifier Low / Median / High Price $22.75 / $22.75 / $52.33	Facility		$22.75	$22.75	$52.33
United Facility/Professional Professional Modifier Low / Median / High Price $13.65 / $13.65 / $56.02	Professional		$13.65	$13.65	$56.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $22.75 / $22.75 / $22.75	Professional		$22.75	$22.75	$22.75