Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.00 / $2.00 / $2.00	Facility		$2.00	$2.00	$2.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1.00 / $2.00 / $3.02	Professional		$1.00	$2.00	$3.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3.72 / $4.68 / $6.76	Professional		$3.72	$4.68	$6.76
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $29.51 / $151.36	Professional		$28.18	$29.51	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $2.69 / $4.47 / $19.05	Facility		$2.69	$4.47	$19.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $1.95 / $2.88 / $9.12	Professional		$1.95	$2.88	$9.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $4.17 / $6.03 / $8.13	Professional		$4.17	$6.03	$8.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $6.46 / $6.76 / $9.12	Professional		$6.46	$6.76	$9.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $25.70	Professional		$25.70	$25.70	$25.70
United Facility/Professional Facility Modifier Low / Median / High Price $1.95 / $1.95 / $2.88	Facility		$1.95	$1.95	$2.88
United Facility/Professional Professional Modifier Low / Median / High Price $1.91 / $1.95 / $3.39	Professional		$1.91	$1.95	$3.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $6.76 / $6.76 / $6.76	Professional		$6.76	$6.76	$6.76