Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $29.51 / $29.51	Facility		$12.88	$29.51	$29.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $15.49 / $8,709.64	Professional		$12.02	$15.49	$8,709.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $13.18 / $19.95	Professional		$12.88	$13.18	$19.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $31.62 / $58.88	Professional		$13.49	$31.62	$58.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $16.22 / $32.36	Facility		$13.18	$16.22	$32.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $14.45 / $102.33	Professional		$13.18	$14.45	$102.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $20.89 / $28.84	Professional		$16.22	$20.89	$28.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $50.12 / $52.48	Professional		$22.39	$50.12	$52.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $22.91 / $27.54	Professional		$13.80	$22.91	$27.54
United Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $12.88 / $12.88	Facility		$12.88	$12.88	$12.88
United Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $13.18 / $15.14	Professional		$12.88	$13.18	$15.14
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $14.79 / $14.79	Facility		$14.79	$14.79	$14.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $14.79 / $14.79	Professional		$11.75	$14.79	$14.79