Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.32 / $49.32 / $53.76	Facility		$49.32	$49.32	$53.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $24.05 / $26.81	Professional		$21.28	$24.05	$26.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.94 / $31.80 / $50.69	Professional		$12.94	$31.80	$50.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.83 / $27.95 / $48.37	Professional		$25.83	$27.95	$48.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $16.43 / $27.67 / $70.95	Facility		$16.43	$27.67	$70.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.64 / $32.60 / $138.19	Professional		$16.64	$32.60	$138.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $18.11 / $35.93 / $56.94	Facility		$18.11	$35.93	$56.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $18.11 / $35.93 / $56.94	Professional		$18.11	$35.93	$56.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.89 / $32.34 / $56.39	Professional		$26.89	$32.34	$56.39
United Facility/Professional Professional Modifier Low / Median / High Price $27.64 / $27.64 / $55.28	Professional		$27.64	$27.64	$55.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $27.64 / $27.64 / $27.64	Professional		$27.64	$27.64	$27.64