Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $63.10	Professional		$52.48	$52.48	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $70.79 / $89.13	Professional		$44.67	$70.79	$89.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $64.57 / $151.36	Professional		$61.66	$64.57	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $69.18 / $123.03	Facility		$52.48	$69.18	$123.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $47.86 / $128.82	Professional		$35.48	$47.86	$128.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $69.18 / $151.36	Professional		$50.12	$69.18	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $50.12	Professional		$47.86	$47.86	$50.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $52.48	Professional		$43.65	$43.65	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $75.86 / $123.03	Facility		$35.48	$75.86	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $58.88	Professional		$35.48	$35.48	$58.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95