Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.84 / $61.99 / $115.31	Facility		$12.84	$61.99	$115.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.97 / $36.86 / $41.11	Professional		$27.97	$36.86	$41.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.90 / $77.03 / $96.29	Professional		$50.90	$77.03	$96.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.38 / $76.70 / $141.46	Professional		$42.38	$76.70	$141.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.38 / $59.36 / $113.15	Facility		$42.38	$59.36	$113.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.38 / $54.44 / $184.32	Professional		$42.38	$54.44	$184.32
Midlands Facility/Professional Facility Modifier Low / Median / High Price $54.69 / $77.70 / $128.22	Facility		$54.69	$77.70	$128.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.64 / $77.70 / $110.61	Professional		$52.64	$77.70	$110.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.24 / $42.38 / $75.65	Professional		$41.24	$42.38	$75.65
United Facility/Professional Professional Modifier Low / Median / High Price $37.29 / $42.38 / $92.39	Professional		$37.29	$42.38	$92.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $42.38 / $42.38 / $42.38	Professional		$42.38	$42.38	$42.38