Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.83 / $70.42 / $70.42	Facility		$29.83	$70.42	$70.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $21.70 / $114.86	Professional		$21.70	$21.70	$114.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $27.16 / $48.99	Professional		$21.70	$27.16	$48.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $40.24 / $148.32	Professional		$21.70	$40.24	$148.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.76 / $33.39 / $76.77	Facility		$19.76	$33.39	$76.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.76 / $22.00 / $933.68	Professional		$19.76	$22.00	$933.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $28.22 / $37.86 / $69.56	Facility		$28.22	$37.86	$69.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $29.64 / $35.79 / $72.68	Professional		$29.64	$35.79	$72.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.33 / $43.07 / $46.99	Professional		$26.33	$43.07	$46.99
United Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $22.35 / $25.82	Professional		$21.70	$22.35	$25.82
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $21.63 / $21.63 / $21.63	Facility		$21.63	$21.63	$21.63
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $17.09 / $21.63 / $21.63	Professional		$17.09	$21.63	$21.63