Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.49 / $42.49 / $56.22	Facility		$42.49	$42.49	$56.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.95 / $37.45 / $120.00	Professional		$26.95	$37.45	$120.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $41.32 / $41.32 / $41.32	Professional	25	$41.32	$41.32	$41.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $57.74 / $91.59	Professional		$32.97	$57.74	$91.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $30.15 / $52.46 / $124.68	Professional		$30.15	$52.46	$124.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.95 / $45.55 / $74.98	Facility		$26.95	$45.55	$74.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.42 / $70.01 / $191.14	Professional		$43.42	$70.01	$191.14
Midlands Facility/Professional Facility Modifier Low / Median / High Price $43.19 / $59.74 / $78.48	Facility		$43.19	$59.74	$78.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $61.42 / $82.87	Professional		$43.19	$61.42	$82.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $50.41 / $73.54	Professional		$28.28	$50.41	$73.54
United Facility/Professional Professional Modifier Low / Median / High Price $41.44 / $55.17 / $91.65	Professional		$41.44	$55.17	$91.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $43.40 / $56.30	Professional		$35.79	$43.40	$56.30