Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.89 / $41.89 / $80.19	Facility		$41.89	$41.89	$80.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $36.28 / $41.89	Professional		$36.28	$36.28	$41.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $39.36 / $52.39	Professional		$36.28	$39.36	$52.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $64.23 / $100.83	Professional		$36.28	$64.23	$100.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.26 / $41.89 / $61.64	Facility		$36.26	$41.89	$61.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.26 / $40.36 / $156.44	Professional		$36.26	$40.36	$156.44
Midlands Facility/Professional Facility Modifier Low / Median / High Price $42.96 / $54.39 / $71.56	Facility		$42.96	$54.39	$71.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $42.96 / $46.07 / $77.02	Professional		$42.96	$46.07	$77.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.97 / $71.89 / $75.79	Professional		$36.97	$71.89	$75.79
United Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $37.36 / $43.17	Professional		$36.28	$37.36	$43.17
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $39.68 / $39.68 / $39.68	Facility		$39.68	$39.68	$39.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $39.68 / $39.68	Professional		$31.35	$39.68	$39.68