Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.02 / $64.57	Professional		$25.12	$38.02	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $87.10	Professional		$58.88	$75.86	$87.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $107.15	Professional		$58.88	$79.43	$107.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $64.57 / $107.15	Facility		$41.69	$64.57	$107.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $39.81 / $154.88	Professional		$28.18	$39.81	$154.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $147.91	Professional		$64.57	$75.86	$147.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $154.88	Professional		$97.72	$97.72	$154.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $114.82	Professional		$93.33	$93.33	$114.82
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $89.13	Facility		$29.51	$29.51	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $29.51 / $48.98	Professional		$28.18	$29.51	$48.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48