Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $12.59 / $19.05	Facility		$12.02	$12.59	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $12.02 / $20.89	Professional		$12.02	$12.02	$20.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10.72 / $223.87 / $269.15	Facility		$10.72	$223.87	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $12.88 / $15.85	Professional		$12.59	$12.88	$15.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $13.80 / $25.70	Professional		$10.72	$13.80	$25.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $15.14 / $21.88	Facility		$8.71	$15.14	$21.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $12.30 / $18.62	Professional		$12.30	$12.30	$18.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $15.49 / $19.50	Professional		$6.03	$15.49	$19.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $208.93 / $269.15	Facility		$10.00	$208.93	$269.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $10.00 / $15.49	Professional		$10.00	$10.00	$15.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $15.49 / $16.98	Professional		$14.13	$15.49	$16.98
United Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $12.59 / $20.89	Facility		$12.59	$12.59	$20.89
United Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $16.22 / $125.89	Professional		$12.59	$16.22	$125.89
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $12.59 / $12.59	Facility		$12.59	$12.59	$12.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $12.59 / $12.59	Professional		$12.59	$12.59	$12.59