Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.33 / $50.62 / $292.60	Facility		$31.33	$50.62	$292.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.48 / $18.64 / $163.68	Professional		$16.48	$18.64	$163.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.23 / $38.52 / $48.14	Professional		$26.23	$38.52	$48.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $21.42 / $37.49 / $103.57	Professional		$21.42	$37.49	$103.57
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.42 / $33.29 / $67.15	Facility		$21.42	$33.29	$67.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.42 / $32.13 / $113.41	Professional		$21.42	$32.13	$113.41
Midlands Facility/Professional Facility Modifier Low / Median / High Price $27.64 / $43.64 / $67.15	Facility		$27.64	$43.64	$67.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $27.64 / $43.64 / $61.70	Professional		$27.64	$43.64	$61.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $20.84 / $21.42 / $38.22	Professional		$20.84	$21.42	$38.22
United Facility/Professional Professional Modifier Low / Median / High Price $18.85 / $21.42 / $50.14	Professional		$18.85	$21.42	$50.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $21.42 / $21.42 / $21.42	Professional		$21.42	$21.42	$21.42