Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.25 / $17.23 / $496.12	Facility		$9.25	$17.23	$496.12
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $24.46 / $37.57 / $111.00	Facility	CQ	$24.46	$37.57	$111.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.48 / $13.46 / $54.00	Professional		$8.48	$13.46	$54.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $5.81 / $11.78 / $29.75	Professional	CQ	$5.81	$11.78	$29.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.27 / $16.27 / $65.00	Facility		$16.27	$16.27	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.12 / $15.15 / $90.08	Professional		$12.12	$15.15	$90.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.78 / $17.05 / $30.71	Professional		$12.78	$17.05	$30.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $10.43 / $19.30 / $100.00	Facility		$10.43	$19.30	$100.00
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $26.96 / $55.33 / $55.33	Facility	CQ	$26.96	$55.33	$55.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.40 / $13.95 / $38.26	Professional		$10.40	$13.95	$38.26
Midlands Facility/Professional Facility Modifier Low / Median / High Price $16.27 / $20.02 / $27.86	Facility		$16.27	$20.02	$27.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $15.18 / $21.33 / $28.58	Professional		$15.18	$21.33	$28.58
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $87.64 / $197.70 / $553.55	Facility		$87.64	$197.70	$553.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.56 / $18.39 / $25.81	Professional		$13.56	$18.39	$25.81
United Facility/Professional Professional Modifier Low / Median / High Price $10.40 / $13.95 / $21.13	Professional		$10.40	$13.95	$21.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $17.89 / $17.89 / $21.10	Professional		$17.89	$17.89	$21.10