Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.05 / $129.31 / $177.38	Facility		$58.05	$129.31	$177.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.09 / $60.00 / $140.44	Professional		$39.09	$60.00	$140.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $39.83 / $49.78	Professional		$39.83	$39.83	$49.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $30.94 / $51.01 / $88.00	Professional		$30.94	$51.01	$88.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.00 / $63.84 / $134.54	Facility		$47.00	$63.84	$134.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $55.43 / $57.88	Professional		$47.00	$55.43	$57.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $33.64 / $47.00 / $52.18	Facility		$33.64	$47.00	$52.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $46.88 / $66.50	Professional		$36.54	$46.88	$66.50
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $285.06 / $790.75 / $1,365.83	Facility		$285.06	$790.75	$1,365.83
United Facility/Professional Professional Modifier Low / Median / High Price $49.05 / $55.43 / $57.88	Professional		$49.05	$55.43	$57.88
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $39.71 / $39.71 / $39.71	Facility		$39.71	$39.71	$39.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $39.71 / $39.71 / $39.71	Professional		$39.71	$39.71	$39.71