Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $48.98 / $371.54	Facility		$17.38	$48.98	$371.54
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $50.12 / $77.62 / $131.83	Facility	CQ	$50.12	$77.62	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $37.15 / $223.87	Professional		$16.22	$37.15	$223.87
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.80 / $13.80 / $13.80	Professional	52	$13.80	$13.80	$13.80
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $17.78 / $35.48 / $407.38	Professional	CO	$17.78	$35.48	$407.38
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $17.38 / $38.02 / $141.25	Professional	CQ	$17.38	$38.02	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $50.12 / $64.57	Facility		$30.90	$50.12	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $29.51 / $44.67	Professional		$23.44	$29.51	$44.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $37.15 / $66.07	Professional		$25.70	$37.15	$66.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $42.66 / $125.89	Facility		$22.39	$42.66	$125.89
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	CQ	$107.15	$107.15	$107.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.88 / $77.62	Professional		$22.91	$33.88	$77.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $41.69 / $46.77	Professional		$34.67	$41.69	$46.77
Midlands Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Facility		$30.90	$30.90	$30.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $46.77	Professional		$33.88	$33.88	$46.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $36.31 / $57.54	Professional		$26.92	$36.31	$57.54
United Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $30.20 / $43.65	Facility		$27.54	$30.20	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $26.30 / $47.86	Professional		$21.88	$26.30	$47.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $40.74	Professional		$34.67	$34.67	$40.74