Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Facility		$38.90	$38.90	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $173.78	Professional		$25.70	$34.67	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $72.44 / $91.20	Professional		$37.15	$72.44	$91.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $53.70 / $151.36	Professional		$50.12	$53.70	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $52.48 / $117.49	Facility		$38.90	$52.48	$117.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $37.15 / $117.49	Professional		$28.18	$37.15	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $58.88 / $117.49	Professional		$37.15	$58.88	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $77.62 / $107.15	Professional		$51.29	$77.62	$107.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $30.90	Professional		$25.70	$25.70	$30.90
United Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.20 / $33.88	Facility		$30.20	$30.20	$33.88
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $30.20 / $50.12	Professional		$27.54	$30.20	$50.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95