Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $44.67 / $125.89	Facility		$34.67	$44.67	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $40.74 / $117.49	Professional		$25.12	$40.74	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $54.95 / $70.79	Professional		$37.15	$54.95	$70.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $36.31 / $107.15	Professional		$25.70	$36.31	$107.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $46.77 / $67.61	Facility		$24.55	$46.77	$67.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $50.12 / $165.96	Professional		$28.84	$50.12	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $63.10 / $69.18	Professional		$47.86	$63.10	$69.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $70.79 / $70.79	Professional		$67.61	$70.79	$70.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $44.67 / $57.54	Professional		$24.55	$44.67	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $42.66 / $77.62	Professional		$28.18	$42.66	$77.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $58.88	Professional		$39.81	$50.12	$58.88