Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $19.00 / $25.00	Professional		$19.00	$19.00	$25.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.56 / $65.09 / $81.37	Professional		$28.56	$65.09	$81.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $46.65 / $85.09	Professional		$39.65	$46.65	$85.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.00 / $19.95 / $60.86	Facility		$19.00	$19.95	$60.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.91 / $108.46 / $259.38	Professional		$52.91	$108.46	$259.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $60.86 / $60.86 / $70.79	Facility		$60.86	$60.86	$70.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.56 / $60.86 / $71.79	Professional		$41.56	$60.86	$71.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $44.45 / $44.45	Professional		$44.45	$44.45	$44.45
United Facility/Professional Professional Modifier Low / Median / High Price $52.91 / $99.42 / $130.83	Professional		$52.91	$99.42	$130.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $38.20 / $38.20	Professional		$38.20	$38.20	$38.20