Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $68.27 / $149.13	Facility		$35.09	$68.27	$149.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.02 / $30.53 / $49.71	Professional		$27.02	$30.53	$49.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $63.32 / $79.15	Professional		$42.14	$63.32	$79.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $57.90 / $95.99	Professional		$35.09	$57.90	$95.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $54.36 / $108.30	Facility		$35.09	$54.36	$108.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.05 / $42.11 / $185.79	Professional		$21.05	$42.11	$185.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $71.48 / $108.30	Facility		$42.11	$71.48	$108.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $71.48 / $102.92	Professional		$42.14	$71.48	$102.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.14 / $35.09 / $62.64	Professional		$34.14	$35.09	$62.64
United Facility/Professional Professional Modifier Low / Median / High Price $21.05 / $21.05 / $85.00	Professional		$21.05	$21.05	$85.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $35.09 / $35.09	Professional		$35.09	$35.09	$35.09