Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.26 / $45.26 / $49.34	Facility		$45.26	$45.26	$49.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.53 / $22.07 / $24.61	Professional		$19.53	$22.07	$24.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $30.47 / $46.98	Professional		$26.17	$30.47	$46.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $52.24 / $79.94	Professional		$25.37	$52.24	$79.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.88 / $36.44 / $120.51	Facility		$28.88	$36.44	$120.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $45.67 / $2,796.55	Professional		$25.37	$45.67	$2,796.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $27.51 / $45.67 / $55.59	Facility		$27.51	$45.67	$55.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $32.74 / $45.67 / $64.69	Professional		$32.74	$45.67	$64.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.69 / $29.68 / $51.75	Professional		$24.69	$29.68	$51.75
United Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $26.13 / $61.53	Professional		$25.37	$26.13	$61.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $25.37 / $25.37	Professional		$25.37	$25.37	$25.37