Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $120.23 / $295.12	Facility		$23.44	$120.23	$295.12
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $67.61 / $112.20 / $380.19	Facility	CO	$67.61	$112.20	$380.19
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $51.29 / $114.82 / $223.87	Facility	CQ	$51.29	$114.82	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $51.29 / $338.84	Professional		$22.91	$51.29	$338.84
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $29.51 / $117.49 / $151.36	Professional	CO	$29.51	$117.49	$151.36
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $30.90 / $51.29 / $144.54	Professional	CQ	$30.90	$51.29	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $50.12 / $64.57	Facility		$43.65	$50.12	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.02 / $57.54	Professional		$30.20	$38.02	$57.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $45.71 / $85.11	Professional		$30.90	$45.71	$85.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $48.98 / $134.90	Facility		$30.90	$48.98	$134.90
Medica Facility/Professional Facility Modifier CO Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	CO	$138.04	$138.04	$138.04
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	CQ	$138.04	$138.04	$138.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $43.65 / $102.33	Professional		$27.54	$43.65	$102.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $53.70 / $64.57	Professional		$43.65	$53.70	$64.57
Midlands Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Facility		$43.65	$43.65	$43.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $64.57	Professional		$38.90	$38.90	$64.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $45.71 / $70.79	Professional		$33.88	$45.71	$70.79
United Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $38.90 / $54.95	Facility		$34.67	$38.90	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $34.67 / $58.88	Professional		$26.92	$34.67	$58.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $52.48	Professional		$44.67	$44.67	$52.48