Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.11 / $66.98 / $95.03	Facility		$37.11	$66.98	$95.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.72 / $29.95 / $33.40	Professional		$22.72	$29.95	$33.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.17 / $62.02 / $77.52	Professional		$42.17	$62.02	$77.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $59.29 / $111.14	Professional		$34.43	$59.29	$111.14
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.43 / $51.65 / $90.43	Facility		$34.43	$51.65	$90.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.27 / $44.43 / $148.97	Professional		$31.27	$44.43	$148.97
Midlands Facility/Professional Facility Modifier Low / Median / High Price $42.17 / $61.97 / $86.00	Facility		$42.17	$61.97	$86.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $42.17 / $64.76 / $89.86	Professional		$42.17	$64.76	$89.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.50 / $34.43 / $61.46	Professional		$33.50	$34.43	$61.46
United Facility/Professional Facility Modifier Low / Median / High Price $34.43 / $34.43 / $79.19	Facility		$34.43	$34.43	$79.19
United Facility/Professional Professional Modifier Low / Median / High Price $30.84 / $34.43 / $70.78	Professional		$30.84	$34.43	$70.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $34.43 / $34.43	Professional		$34.43	$34.43	$34.43