Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $47.86 / $107.15	Facility		$19.95	$47.86	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $26.92 / $64.57	Professional		$15.14	$26.92	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $47.86	Professional		$25.70	$38.90	$47.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $48.98 / $77.62	Professional		$19.95	$48.98	$77.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $28.18 / $74.13	Facility		$19.95	$28.18	$74.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $28.18 / $112.20	Professional		$12.02	$28.18	$112.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $25.70	Professional		$23.99	$23.99	$25.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $21.88 / $42.66	Professional		$19.50	$21.88	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $45.71	Facility		$19.95	$19.95	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.30 / $54.95	Professional		$12.02	$12.30	$54.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95