Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $47.86	Facility		$43.65	$43.65	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $19.05 / $34.67	Professional		$15.14	$19.05	$34.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $29.51 / $46.77	Professional		$26.30	$29.51	$46.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $50.12 / $79.43	Professional		$22.91	$50.12	$79.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $34.67 / $109.65	Facility		$27.54	$34.67	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $43.65 / $165.96	Professional		$22.91	$43.65	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $29.51	Professional		$27.54	$27.54	$29.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $25.12 / $48.98	Professional		$22.39	$25.12	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $25.12 / $61.66	Professional		$22.91	$25.12	$61.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Professional		$22.91	$22.91	$22.91