Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.23 / $192.85 / $450.11	Facility		$77.23	$192.85	$450.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $41.47 / $192.85	Professional		$40.65	$41.47	$192.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $50.26 / $64.81	Professional		$40.65	$50.26	$64.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $72.56 / $108.31	Professional		$40.65	$72.56	$108.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.71 / $82.55 / $192.85	Facility		$44.71	$82.55	$192.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $41.20 / $178.61	Professional		$41.20	$41.20	$178.61
Midlands Facility/Professional Facility Modifier Low / Median / High Price $49.44 / $54.09 / $87.00	Facility		$49.44	$54.09	$87.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $49.44 / $59.51 / $107.06	Professional		$49.44	$59.51	$107.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.80 / $71.77 / $72.56	Professional		$57.80	$71.77	$72.56
United Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $44.72	Professional		$40.65	$40.65	$44.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $32.54 / $41.20 / $41.20	Professional		$32.54	$41.20	$41.20