Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.50 / $74.09 / $252.85	Facility		$30.50	$74.09	$252.85
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $59.18 / $63.09 / $148.19	Facility	CQ	$59.18	$63.09	$148.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.27 / $37.31 / $310.00	Professional		$19.27	$37.31	$310.00
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $20.86 / $20.86 / $20.86	Professional	CO	$20.86	$20.86	$20.86
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $20.60 / $41.17 / $76.93	Professional	CQ	$20.60	$41.17	$76.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.11 / $39.11 / $65.00	Facility		$39.11	$39.11	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.90 / $35.67 / $90.08	Professional		$27.90	$35.67	$90.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.24 / $41.85 / $73.55	Professional		$26.24	$41.85	$73.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.85 / $49.47 / $149.85	Facility		$23.85	$49.47	$149.85
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $62.75 / $127.37 / $127.37	Facility	CQ	$62.75	$127.37	$127.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.02 / $36.89 / $92.02	Professional		$27.02	$36.89	$92.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $39.11 / $49.47 / $67.55	Facility		$39.11	$49.47	$67.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $51.68 / $72.77	Professional		$39.00	$51.68	$72.77
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $76.37 / $232.17 / $650.05	Facility		$76.37	$232.17	$650.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.00 / $41.91 / $59.01	Professional		$31.00	$41.91	$59.01
United Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $33.69 / $53.28	Professional		$24.86	$33.69	$53.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $41.20 / $48.50	Professional		$41.20	$41.20	$48.50