Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.14 / $42.14 / $80.65	Facility		$42.14	$42.14	$80.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.74 / $36.74 / $73.26	Professional		$36.74	$36.74	$73.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.74 / $39.86 / $54.18	Professional		$36.74	$39.86	$54.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.71 / $42.45 / $90.47	Professional		$25.71	$42.45	$90.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.65 / $42.14 / $63.81	Facility		$36.65	$42.14	$63.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $40.81 / $161.83	Professional		$36.65	$40.81	$161.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $43.97 / $54.99 / $73.56	Facility		$43.97	$54.99	$73.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $43.97 / $47.64 / $72.98	Professional		$43.97	$47.64	$72.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.74 / $72.81 / $76.75	Professional		$36.74	$72.81	$76.75
United Facility/Professional Professional Modifier Low / Median / High Price $36.74 / $37.84 / $43.72	Professional		$36.74	$37.84	$43.72
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $40.11 / $40.11 / $40.11	Facility		$40.11	$40.11	$40.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $31.69 / $40.11 / $40.11	Professional		$31.69	$40.11	$40.11