Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.29 / $26.29 / $69.45	Facility		$26.29	$26.29	$69.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.29 / $28.91 / $30.00	Professional		$26.29	$28.91	$30.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.00 / $21.41 / $30.72	Professional		$9.00	$21.41	$30.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $17.60 / $37.51 / $131.63	Professional		$17.60	$37.51	$131.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.80 / $28.91 / $47.70	Facility		$19.80	$28.91	$47.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.40 / $31.80 / $722.89	Professional		$26.40	$31.80	$722.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $19.80 / $21.41 / $24.93	Facility		$19.80	$21.41	$24.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $19.80 / $22.70 / $34.44	Professional		$19.80	$22.70	$34.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.20 / $23.20 / $27.40	Professional		$23.20	$23.20	$27.40
United Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.90 / $36.14	Professional		$30.00	$30.90	$36.14
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $34.79 / $34.79 / $34.79	Facility		$34.79	$34.79	$34.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $27.49 / $34.79 / $34.79	Professional		$27.49	$34.79	$34.79