Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.87 / $95.57 / $217.62	Facility		$29.87	$95.57	$217.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.30 / $27.56 / $96.16	Professional		$19.30	$27.56	$96.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.13 / $23.17 / $27.66	Professional		$22.13	$23.17	$27.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $19.30 / $33.79 / $83.29	Professional		$19.30	$33.79	$83.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.30 / $30.84 / $121.45	Facility		$19.30	$30.84	$121.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.59 / $19.30 / $50.40	Professional		$11.59	$19.30	$50.40
Midlands Facility/Professional Facility Modifier Low / Median / High Price $22.53 / $27.03 / $50.21	Facility		$22.53	$27.03	$50.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $23.17 / $31.00 / $50.40	Professional		$23.17	$31.00	$50.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $91.81 / $91.81 / $91.81	Facility		$91.81	$91.81	$91.81
United Facility/Professional Professional Modifier Low / Median / High Price $11.59 / $15.42 / $44.41	Professional		$11.59	$15.42	$44.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $15.25 / $19.30 / $19.30	Professional		$15.25	$19.30	$19.30