Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.40 / $113.40 / $113.40	Facility		$113.40	$113.40	$113.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $38.46 / $130.00	Professional		$25.17	$38.46	$130.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $41.27 / $144.00 / $144.00	Professional	25	$41.27	$144.00	$144.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.59 / $17.39 / $25.74	Professional	52	$12.59	$17.39	$25.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $53.91 / $89.62	Professional		$34.82	$53.91	$89.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $24.30 / $47.22 / $102.33	Professional		$24.30	$47.22	$102.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.68 / $47.59 / $76.15	Facility		$31.68	$47.59	$76.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.81 / $76.87 / $198.01	Professional		$40.81	$76.87	$198.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $39.29 / $60.00 / $89.62	Facility		$39.29	$60.00	$89.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $56.78 / $89.62	Professional		$39.29	$56.78	$89.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.93 / $51.00 / $101.00	Professional		$26.93	$51.00	$101.00
United Facility/Professional Professional Modifier Low / Median / High Price $38.99 / $59.36 / $100.91	Professional		$38.99	$59.36	$100.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $61.20 / $88.30	Professional		$52.00	$61.20	$88.30