Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.59 / $50.05 / $50.05	Facility		$39.59	$50.05	$50.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.80 / $37.02 / $52.52	Professional		$22.80	$37.02	$52.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.61 / $36.61 / $77.06	Facility		$36.61	$36.61	$77.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $83.63 / $104.53	Professional		$36.61	$83.63	$104.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.56 / $72.03 / $77.06	Professional		$66.56	$72.03	$77.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.02 / $80.62 / $286.64	Facility		$44.02	$80.62	$286.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.90 / $34.95 / $95.72	Professional		$26.90	$34.95	$95.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $76.84 / $77.06 / $92.37	Facility		$76.84	$77.06	$92.37
Midlands Facility/Professional Professional Modifier Low / Median / High Price $62.07 / $82.99 / $147.27	Professional		$62.07	$82.99	$147.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $71.45 / $76.53 / $128.57	Professional		$71.45	$76.53	$128.57
United Facility/Professional Professional Modifier Low / Median / High Price $26.90 / $34.95 / $91.89	Professional		$26.90	$34.95	$91.89
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $66.56 / $66.56 / $66.56	Facility		$66.56	$66.56	$66.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $52.58 / $66.56 / $66.56	Professional		$52.58	$66.56	$66.56