Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.22 / $114.00 / $114.00	Facility		$22.22	$114.00	$114.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.19 / $137.91	Professional		$4.19	$4.19	$137.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $16.30 / $50.83	Professional		$4.19	$16.30	$50.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $80.91 / $355.31	Professional		$4.19	$80.91	$355.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.72 / $24.88 / $186.70	Facility		$14.72	$24.88	$186.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.72 / $16.39 / $3,115.14	Professional		$14.72	$16.39	$3,115.14
Midlands Facility/Professional Facility Modifier Low / Median / High Price $10.99 / $19.21 / $163.00	Facility		$10.99	$19.21	$163.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $10.99 / $50.83 / $205.06	Professional		$10.99	$50.83	$205.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.48 / $8.75 / $212.10	Professional		$7.48	$8.75	$212.10
United Facility/Professional Professional Modifier Low / Median / High Price $4.19 / $4.26 / $4.99	Professional		$4.19	$4.26	$4.99
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $16.11 / $16.11 / $16.11	Facility		$16.11	$16.11	$16.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $12.73 / $16.11 / $16.11	Professional		$12.73	$16.11	$16.11