Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $29.51 / $66.07	Professional		$15.14	$29.51	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $28.18 / $35.48	Professional		$26.30	$28.18	$35.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.92 / $70.79	Professional		$20.89	$26.92	$70.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $28.18 / $60.26	Facility		$19.95	$28.18	$60.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $14.13 / $52.48	Professional		$10.96	$14.13	$52.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $27.54 / $52.48	Professional		$26.92	$27.54	$52.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $53.70	Professional		$40.74	$51.29	$53.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $34.67 / $52.48	Professional		$24.55	$34.67	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $12.02 / $13.49	Facility		$12.02	$12.02	$13.49
United Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $12.02 / $20.42	Professional		$10.72	$12.02	$20.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Professional		$21.88	$21.88	$21.88