Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.98 / $398.00 / $7,100.00	Facility		$114.98	$398.00	$7,100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.56 / $60.02 / $1,760.00	Professional		$35.56	$60.02	$1,760.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $79.14 / $187.77	Professional		$39.38	$79.14	$187.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.48 / $80.27 / $121.50	Professional		$72.48	$80.27	$121.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.84 / $60.52 / $110.12	Facility		$42.84	$60.52	$110.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $42.84 / $664.56	Professional		$42.84	$42.84	$664.56
Midlands Facility/Professional Facility Modifier Low / Median / High Price $37.24 / $95.56 / $187.77	Facility		$37.24	$95.56	$187.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.94 / $103.16 / $297.14	Professional		$69.94	$103.16	$297.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.41 / $93.52 / $105.98	Professional		$46.41	$93.52	$105.98
United Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $42.84 / $44.13	Professional		$42.84	$42.84	$44.13
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $23.13 / $23.13 / $23.13	Facility		$23.13	$23.13	$23.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $18.27 / $23.13 / $23.13	Professional		$18.27	$23.13	$23.13