Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.24 / $39.42 / $140.71	Facility		$23.24	$39.42	$140.71
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $279.64 / $279.64 / $279.64	Facility	CO	$279.64	$279.64	$279.64
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $59.20 / $59.20 / $59.20	Facility	CQ	$59.20	$59.20	$59.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.28 / $32.06 / $312.00	Professional		$19.28	$32.06	$312.00
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $27.38 / $100.00 / $100.00	Professional	CO	$27.38	$100.00	$100.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $12.92 / $17.64 / $53.04	Professional	CQ	$12.92	$17.64	$53.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.57 / $37.57 / $65.00	Facility		$37.57	$37.57	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.90 / $35.43 / $92.15	Professional		$27.90	$35.43	$92.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.37 / $41.84 / $65.00	Professional		$28.37	$41.84	$65.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.06 / $45.56 / $149.85	Facility		$23.06	$45.56	$149.85
Medica Facility/Professional Facility Modifier CO Low / Median / High Price $61.71 / $127.37 / $127.37	Facility	CO	$61.71	$127.37	$127.37
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $61.71 / $127.37 / $127.37	Facility	CQ	$61.71	$127.37	$127.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.94 / $33.90 / $101.35	Professional		$27.94	$33.90	$101.35
Midlands Facility/Professional Facility Modifier Low / Median / High Price $37.57 / $49.16 / $65.34	Facility		$37.57	$49.16	$65.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $39.15 / $49.64 / $69.95	Professional		$39.15	$49.64	$69.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.75 / $41.74 / $58.94	Professional		$30.75	$41.74	$58.94
United Facility/Professional Professional Modifier Low / Median / High Price $26.49 / $32.86 / $55.29	Professional		$26.49	$32.86	$55.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $41.20 / $48.50	Professional		$41.20	$41.20	$48.50