Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.67 / $66.67 / $198.24	Facility		$66.67	$66.67	$198.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.46 / $66.67 / $4,622.39	Professional		$55.46	$66.67	$4,622.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.66 / $69.38 / $86.72	Professional		$66.66	$69.38	$86.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $137.74 / $158.18 / $161.51	Professional		$137.74	$158.18	$161.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.09 / $66.66 / $82.14	Facility		$51.09	$66.66	$82.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.78 / $57.78 / $79.16	Professional		$57.78	$57.78	$79.16
Midlands Facility/Professional Facility Modifier Low / Median / High Price $4,770.00 / $5,565.00 / $7,473.00	Facility		$4,770.00	$5,565.00	$7,473.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.66 / $66.66 / $66.66	Professional		$66.66	$66.66	$66.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.41 / $187.28 / $211.36	Professional		$101.41	$187.28	$211.36
United Facility/Professional Professional Modifier Low / Median / High Price $57.78 / $57.78 / $75.17	Professional		$57.78	$57.78	$75.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $43.89 / $55.56 / $55.56	Professional		$43.89	$55.56	$55.56