Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.58 / $42.00 / $148.94	Facility		$21.58	$42.00	$148.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.36 / $42.00 / $85.60	Professional		$11.36	$42.00	$85.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.09 / $15.43 / $16.36	Professional		$13.09	$15.43	$16.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $11.36 / $20.56 / $113.80	Professional		$11.36	$20.56	$113.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.01 / $28.00 / $60.78	Facility		$14.01	$28.00	$60.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.68 / $11.68 / $46.79	Professional		$11.68	$11.68	$46.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $14.01 / $17.88 / $48.78	Facility		$14.01	$17.88	$48.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $14.01 / $35.93 / $98.79	Professional		$14.01	$35.93	$98.79
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,257.24 / $7,677.49 / $13,261.09	Facility		$1,257.24	$7,677.49	$13,261.09
United Facility/Professional Professional Modifier Low / Median / High Price $11.36 / $11.36 / $11.70	Professional		$11.36	$11.36	$11.70
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $11.68 / $11.68 / $11.68	Facility		$11.68	$11.68	$11.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $11.68 / $11.68 / $11.68	Professional		$11.68	$11.68	$11.68