Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.92 / $22.98 / $28.68	Facility		$17.92	$22.98	$28.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.18 / $15.10 / $47.00	Professional		$11.18	$15.10	$47.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $19.30 / $49.00 / $51.88	Professional	25	$19.30	$49.00	$51.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.11 / $23.42 / $32.78	Professional		$12.11	$23.42	$32.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $10.91 / $19.07 / $39.97	Professional		$10.91	$19.07	$39.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.10 / $18.63 / $27.37	Facility		$12.10	$18.63	$27.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $23.42 / $199.96	Professional		$15.00	$23.42	$199.96
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $20.17 / $20.17 / $26.68	Professional	25	$20.17	$20.17	$26.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $23.91 / $33.29	Facility		$15.85	$23.91	$33.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $23.53 / $29.84	Professional		$15.85	$23.53	$29.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.31 / $20.01 / $27.06	Professional		$11.31	$20.01	$27.06
United Facility/Professional Professional Modifier Low / Median / High Price $14.74 / $20.42 / $33.74	Professional		$14.74	$20.42	$33.74
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $17.00 / $20.00 / $24.60	Professional		$17.00	$20.00	$24.60