Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.54 / $129.83 / $406.57	Facility		$35.54	$129.83	$406.57
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $101.00 / $548.44 / $548.44	Facility	CO	$101.00	$548.44	$548.44
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $58.53 / $255.18 / $878.58	Facility	CQ	$58.53	$255.18	$878.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.39 / $41.76 / $324.00	Professional		$17.39	$41.76	$324.00
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $18.23 / $18.52 / $29.67	Professional	CO	$18.23	$18.52	$29.67
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $16.85 / $46.65 / $92.26	Professional	CQ	$16.85	$46.65	$92.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.70 / $33.70 / $65.00	Facility		$33.70	$33.70	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.08 / $34.67 / $90.08	Professional		$25.08	$34.67	$90.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.59 / $39.24 / $70.64	Professional		$26.59	$39.24	$70.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.29 / $49.59 / $134.74	Facility		$22.29	$49.59	$134.74
Medica Facility/Professional Facility Modifier CO Low / Median / High Price $56.39 / $114.53 / $114.53	Facility	CO	$56.39	$114.53	$114.53
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $56.39 / $114.53 / $114.53	Facility	CQ	$56.39	$114.53	$114.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $34.47 / $85.90	Professional		$25.04	$34.47	$85.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $33.70 / $44.45 / $58.90	Facility		$33.70	$44.45	$58.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $35.86 / $44.70 / $65.20	Professional		$35.86	$44.70	$65.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.90 / $37.72 / $52.96	Professional		$27.90	$37.72	$52.96
United Facility/Professional Professional Modifier Low / Median / High Price $24.45 / $28.35 / $52.00	Professional		$24.45	$28.35	$52.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $37.10 / $37.10 / $43.60	Professional		$37.10	$37.10	$43.60