Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,051.40 / $1,051.40 / $1,051.40	Facility		$1,051.40	$1,051.40	$1,051.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.15 / $35.84 / $36.25	Professional		$12.15	$35.84	$36.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.31 / $50.25 / $62.81	Professional		$46.31	$50.25	$62.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.01 / $43.27 / $78.31	Professional		$33.01	$43.27	$78.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.56 / $45.67 / $57.05	Facility		$29.56	$45.67	$57.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $15.00 / $57.05	Professional		$15.00	$15.00	$57.05
Midlands Facility/Professional Facility Modifier Low / Median / High Price $43.10 / $47.60 / $62.28	Facility		$43.10	$47.60	$62.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $49.47 / $71.13	Professional		$38.35	$49.47	$71.13
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $209.52 / $209.52 / $209.52	Facility		$209.52	$209.52	$209.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $59.00 / $85.30	Professional		$22.00	$59.00	$85.30
United Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $15.00 / $26.12	Professional		$15.00	$15.00	$26.12
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $38.94 / $38.94 / $38.94	Facility		$38.94	$38.94	$38.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $30.76 / $38.94 / $38.94	Professional		$30.76	$38.94	$38.94