Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $105.60	Facility		$55.00	$55.00	$105.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $47.97 / $55.00	Professional		$47.97	$47.97	$55.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $52.05 / $62.95	Professional		$47.97	$52.05	$62.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $74.73 / $115.23	Professional		$47.97	$74.73	$115.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $55.00 / $87.12	Facility		$48.00	$55.00	$87.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $48.00 / $213.78	Professional		$48.00	$48.00	$213.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $57.18 / $72.63 / $100.04	Facility		$57.18	$72.63	$100.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.18 / $57.88 / $74.28	Professional		$57.18	$57.88	$74.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.85 / $95.06 / $100.21	Professional		$47.85	$95.06	$100.21
United Facility/Professional Facility Modifier Low / Median / High Price $79.58 / $79.58 / $79.58	Facility		$79.58	$79.58	$79.58
United Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $47.97 / $50.89	Professional		$47.97	$47.97	$50.89
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $48.00 / $48.00	Facility		$48.00	$48.00	$48.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $37.92 / $48.00 / $48.00	Professional		$37.92	$48.00	$48.00