Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $45.71	Facility		$42.66	$42.66	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $19.95 / $33.88	Professional		$14.13	$19.95	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $36.31 / $61.66	Professional		$15.14	$36.31	$61.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $30.20 / $229.09	Professional		$16.98	$30.20	$229.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $56.23 / $177.83	Facility		$22.39	$56.23	$177.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $36.31 / $316.23	Professional		$16.98	$36.31	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $56.23 / $61.66	Professional		$26.92	$56.23	$61.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $63.10 / $63.10	Professional		$61.66	$63.10	$63.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $31.62 / $40.74	Professional		$17.78	$31.62	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.91 / $53.70	Professional		$22.39	$22.91	$53.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Professional		$22.39	$22.39	$22.39