Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.80 / $29.69 / $30.58	Facility		$19.80	$29.69	$30.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $14.84 / $8,614.75	Professional		$13.49	$14.84	$8,614.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $16.30 / $22.48	Professional		$13.49	$16.30	$22.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $29.52 / $64.98	Professional		$13.49	$29.52	$64.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.12 / $20.34 / $31.71	Facility		$13.12	$20.34	$31.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.12 / $14.61 / $102.03	Professional		$13.12	$14.61	$102.03
Midlands Facility/Professional Facility Modifier Low / Median / High Price $16.30 / $21.65 / $31.00	Facility		$16.30	$21.65	$31.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $16.30 / $20.72 / $52.64	Professional		$16.30	$20.72	$52.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $26.78 / $28.72	Professional		$13.49	$26.78	$28.72
United Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $13.89 / $16.05	Professional		$13.49	$13.89	$16.05
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $14.36 / $14.36 / $14.36	Facility		$14.36	$14.36	$14.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $11.34 / $14.36 / $14.36	Professional		$11.34	$14.36	$14.36