Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1.00 / $28.84 / $28.84	Facility		$1.00	$28.84	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1.00 / $1.00 / $107.15	Professional		$1.00	$1.00	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $25.70 / $31.62	Professional		$18.62	$25.70	$31.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $151.36	Professional		$21.88	$21.88	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $2.04 / $8.51 / $28.84	Facility		$2.04	$8.51	$28.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $1.70 / $1.70 / $28.84	Professional		$1.70	$1.70	$28.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1.41 / $18.62 / $28.84	Professional		$1.41	$18.62	$28.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1.41 / $20.42 / $20.42	Professional		$1.41	$20.42	$20.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.11 / $38.90	Professional		$28.84	$33.11	$38.90
United Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $17.78 / $17.78	Facility		$17.78	$17.78	$17.78
United Facility/Professional Professional Modifier Low / Median / High Price $1.74 / $1.74 / $2.14	Professional		$1.74	$1.74	$2.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1.00 / $1.26 / $1.26	Professional		$1.00	$1.26	$1.26