Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Facility		$30.00	$30.00	$30.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.48 / $19.48 / $30.00	Professional		$19.48	$19.48	$30.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $26.25 / $34.57	Professional		$21.00	$26.25	$34.57
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $19.48 / $29.97 / $41.49	Professional		$19.48	$29.97	$41.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.48 / $30.00 / $443.66	Facility		$19.48	$30.00	$443.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $19.48 / $19.48 / $46.34	Professional		$19.48	$19.48	$46.34
Midlands Facility/Professional Facility Modifier Low / Median / High Price $23.37 / $32.02 / $34.57	Facility		$23.37	$32.02	$34.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $23.37 / $32.02 / $34.57	Professional		$23.37	$32.02	$34.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $36.00 / $43.80	Professional		$36.00	$36.00	$43.80
United Facility/Professional Professional Modifier Low / Median / High Price $19.48 / $19.48 / $24.04	Professional		$19.48	$19.48	$24.04
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $19.48 / $19.48 / $19.48	Facility		$19.48	$19.48	$19.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $15.39 / $19.48 / $19.48	Professional		$15.39	$19.48	$19.48