Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.68 / $103.20 / $210.57	Facility		$32.68	$103.20	$210.57
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $92.58 / $260.68 / $260.68	Facility	CO	$92.58	$260.68	$260.68
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $51.04 / $185.53 / $187.33	Facility	CQ	$51.04	$185.53	$187.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.73 / $40.34 / $435.00	Professional		$19.73	$40.34	$435.00
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $29.67 / $52.12 / $152.00	Professional	CO	$29.67	$52.12	$152.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $29.67 / $45.34 / $92.63	Professional	CQ	$29.67	$45.34	$92.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.77 / $43.77 / $65.00	Facility		$43.77	$43.77	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.43 / $38.65 / $90.08	Professional		$30.43	$38.65	$90.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.92 / $43.78 / $73.41	Professional		$27.92	$43.78	$73.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.88 / $50.49 / $161.97	Facility		$26.88	$50.49	$161.97
Medica Facility/Professional Facility Modifier CO Low / Median / High Price $65.76 / $137.66 / $137.66	Facility	CO	$65.76	$137.66	$137.66
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $65.76 / $137.66 / $137.66	Facility	CQ	$65.76	$137.66	$137.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.35 / $38.92 / $102.09	Professional		$28.35	$38.92	$102.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $43.77 / $53.18 / $73.00	Facility		$43.77	$53.18	$73.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $55.03 / $79.26	Professional		$40.00	$55.03	$79.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.17 / $44.91 / $63.74	Professional		$33.17	$44.91	$63.74
United Facility/Professional Professional Modifier Low / Median / High Price $27.59 / $37.79 / $56.49	Professional		$27.59	$37.79	$56.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $44.60 / $44.60 / $52.40	Professional		$44.60	$44.60	$52.40