Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $91.20	Facility		$83.18	$83.18	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $36.31 / $41.69	Professional		$19.95	$36.31	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $52.48 / $72.44	Professional		$22.91	$52.48	$72.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $58.88 / $79.43	Professional		$37.15	$58.88	$79.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $50.12 / $208.93	Facility		$28.84	$50.12	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $52.48 / $218.78	Professional		$26.30	$52.48	$218.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $72.44	Professional		$52.48	$63.10	$72.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $47.86 / $93.33	Professional		$42.66	$47.86	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.30 / $117.49	Professional		$26.30	$26.30	$117.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65