Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $7.57 / $22.75 / $61.29	Facility		$7.57	$22.75	$61.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6.75 / $15.69 / $21.88	Professional		$6.75	$15.69	$21.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.31 / $10.31 / $12.89	Professional		$10.31	$10.31	$12.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $4.26 / $15.69 / $28.40	Professional		$4.26	$15.69	$28.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $6.88 / $18.82 / $70.91	Facility		$6.88	$18.82	$70.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $5.74 / $15.69 / $16.64	Professional		$5.74	$15.69	$16.64
Midlands Facility/Professional Facility Modifier Low / Median / High Price $3.00 / $9.05 / $18.82	Facility		$3.00	$9.05	$18.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $8.01 / $18.82	Professional		$3.00	$8.01	$18.82
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,210.16 / $2,570.17 / $4,439.38	Facility		$1,210.16	$2,570.17	$4,439.38
United Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $15.69 / $16.00	Professional		$15.69	$15.69	$16.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $15.69 / $15.69 / $15.69	Facility		$15.69	$15.69	$15.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $15.69 / $15.69	Professional		$15.69	$15.69	$15.69