Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.54 / $78.88 / $149.13	Facility		$40.54	$78.88	$149.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.22 / $39.25 / $198.40	Professional		$31.22	$39.25	$198.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.66 / $73.77 / $92.21	Professional		$48.66	$73.77	$92.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.61 / $70.95 / $151.56	Professional		$44.61	$70.95	$151.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.54 / $52.72 / $103.81	Facility		$40.54	$52.72	$103.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.33 / $41.77 / $188.54	Professional		$24.33	$41.77	$188.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $48.66 / $74.34 / $100.38	Facility		$48.66	$74.34	$100.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $48.66 / $74.34 / $103.40	Professional		$48.66	$74.34	$103.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $832.92 / $832.92 / $832.92	Facility		$832.92	$832.92	$832.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $47.44 / $82.72	Professional		$39.46	$47.44	$82.72
United Facility/Professional Professional Modifier Low / Median / High Price $24.33 / $24.33 / $88.40	Professional		$24.33	$24.33	$88.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $40.54 / $40.54	Professional		$40.54	$40.54	$40.54