Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $15.85 / $114.82	Facility		$15.85	$15.85	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $15.14 / $87.10	Professional		$10.96	$15.14	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $28.18 / $39.81	Professional		$22.39	$28.18	$39.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $14.79 / $54.95	Professional		$7.41	$14.79	$54.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $26.92 / $89.13	Facility		$15.85	$26.92	$89.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $16.98 / $53.70	Professional		$11.48	$16.98	$53.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $36.31 / $51.29	Professional		$24.55	$36.31	$51.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $39.81 / $53.70	Professional		$38.90	$39.81	$53.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $30.20	Professional		$25.12	$25.12	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $11.48 / $16.98	Facility		$11.48	$11.48	$16.98
United Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $11.48 / $19.95	Professional		$11.22	$11.48	$19.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Professional		$42.66	$42.66	$42.66