Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.88 / $40.99 / $62.50	Facility		$26.88	$40.99	$62.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.46 / $42.72 / $123.71	Professional		$17.46	$42.72	$123.71
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $128.00 / $128.00 / $128.00	Professional	25	$128.00	$128.00	$128.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.84 / $46.88 / $103.84	Professional		$24.84	$46.88	$103.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $16.69 / $44.35 / $100.80	Professional		$16.69	$44.35	$100.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.80 / $40.61 / $77.31	Facility		$17.80	$40.61	$77.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.60 / $66.54 / $156.41	Professional		$40.60	$66.54	$156.41
Midlands Facility/Professional Facility Modifier Low / Median / High Price $26.21 / $65.01 / $103.84	Facility		$26.21	$65.01	$103.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $26.21 / $60.41 / $103.84	Professional		$26.21	$60.41	$103.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.69 / $39.22 / $79.36	Professional		$16.69	$39.22	$79.36
United Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $58.51 / $93.65	Professional		$42.35	$58.51	$93.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $25.30 / $30.90 / $73.80	Professional		$25.30	$30.90	$73.80