Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $38.02 / $43.65	Facility		$33.11	$38.02	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $36.31 / $61.66	Professional		$25.70	$36.31	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $38.90 / $87.10	Professional		$23.99	$38.90	$87.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.88 / $229.09	Professional		$27.54	$33.88	$229.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $44.67 / $75.86	Facility		$30.90	$44.67	$75.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $218.78	Professional		$33.88	$57.54	$218.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $74.13 / $93.33	Professional		$67.61	$74.13	$93.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $81.28	Professional		$33.88	$42.66	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $52.48 / $91.20	Professional		$33.88	$52.48	$91.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $56.23 / $66.07	Professional		$52.48	$56.23	$66.07