Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.89 / $30.89 / $33.68	Facility		$30.89	$30.89	$33.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.33 / $15.06 / $16.79	Professional		$13.33	$15.06	$16.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.94 / $20.65 / $27.48	Professional		$12.94	$20.65	$27.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $26.28 / $31.83	Professional		$18.19	$26.28	$31.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $20.78 / $82.50	Facility		$15.00	$20.78	$82.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.97 / $24.19 / $91.00	Professional		$14.97	$24.19	$91.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $18.11 / $28.20 / $36.59	Facility		$18.11	$28.20	$36.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $18.11 / $28.20 / $36.59	Professional		$18.11	$28.20	$36.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $30.92 / $37.11	Professional		$18.19	$30.92	$37.11
United Facility/Professional Professional Modifier Low / Median / High Price $15.12 / $15.57 / $45.71	Professional		$15.12	$15.57	$45.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $18.19 / $18.19	Professional		$18.19	$18.19	$18.19