Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.93 / $121.49 / $156.34	Facility		$41.93	$121.49	$156.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.70 / $23.39 / $26.38	Professional		$20.70	$23.39	$26.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.26 / $48.96 / $61.20	Professional		$32.26	$48.96	$61.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $48.65 / $78.30	Professional		$26.88	$48.65	$78.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.88 / $34.94 / $72.20	Facility		$26.88	$34.94	$72.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.13 / $28.00 / $106.19	Professional		$16.13	$28.00	$106.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $32.26 / $49.29 / $72.20	Facility		$32.26	$49.29	$72.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $32.26 / $48.30 / $70.16	Professional		$32.26	$48.30	$70.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.15 / $31.45 / $54.84	Professional		$26.15	$31.45	$54.84
United Facility/Professional Professional Modifier Low / Median / High Price $16.13 / $16.13 / $49.73	Professional		$16.13	$16.13	$49.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $26.88 / $26.88	Professional		$26.88	$26.88	$26.88