Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $67.61 / $93.33	Professional		$61.66	$67.61	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $199.53	Professional		$69.18	$102.33	$199.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $0.85 / $1.15 / $100.00	Professional		$0.85	$1.15	$100.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $93.33 / $144.54	Facility		$56.23	$93.33	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $112.20 / $575.44	Professional		$66.07	$112.20	$575.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $128.82 / $169.82	Professional		$53.70	$128.82	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $75.86 / $169.82	Professional		$66.07	$75.86	$169.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $93.33 / $128.82	Professional		$58.88	$93.33	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $104.71 / $181.97	Professional		$60.26	$104.71	$181.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $47.86 / $51.29	Professional		$39.81	$47.86	$51.29