Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $95.49 / $489.19	Facility		$35.09	$95.49	$489.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.02 / $48.18 / $268.77	Professional		$27.02	$48.18	$268.77
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 / $61.41 / $92.58	Professional		$35.09	$61.41	$92.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $54.36 / $129.56	Facility		$35.09	$54.36	$129.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.05 / $42.14 / $196.86	Professional		$21.05	$42.14	$196.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $71.48 / $110.01	Facility		$42.11	$71.48	$110.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $72.29 / $102.92	Professional		$42.14	$72.29	$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