Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.93 / $72.41 / $116.85	Facility		$38.93	$72.41	$116.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.49 / $25.81 / $60.06	Professional		$20.49	$25.81	$60.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $32.45 / $58.38	Professional		$30.56	$32.45	$58.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $64.77 / $85.46	Professional		$26.61	$64.77	$85.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.29 / $40.86 / $126.40	Facility		$31.29	$40.86	$126.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $47.90 / $3,255.68	Professional		$26.61	$47.90	$3,255.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $34.34 / $47.90 / $66.00	Facility		$34.34	$47.90	$66.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $34.34 / $50.83 / $76.31	Professional		$34.34	$50.83	$76.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.89 / $31.13 / $54.28	Professional		$25.89	$31.13	$54.28
United Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $27.41 / $114.61	Professional		$26.61	$27.41	$114.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $26.61 / $26.61 / $26.61	Professional		$26.61	$26.61	$26.61