Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.59 / $71.20 / $71.20	Professional		$41.59	$71.20	$71.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.08 / $115.33 / $127.59	Professional		$96.08	$115.33	$127.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.08 / $64.04 / $1,787.90	Professional		$41.08	$64.04	$1,787.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.54 / $120.12 / $1,607.00	Facility		$91.54	$120.12	$1,607.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.29 / $114.00 / $633.00	Professional		$57.29	$114.00	$633.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $72.09 / $108.41 / $136.60	Facility		$72.09	$108.41	$136.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $108.41 / $136.60	Professional		$76.00	$108.41	$136.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.20 / $84.30 / $110.40	Professional		$77.20	$84.30	$110.40
United Facility/Professional Facility Modifier Low / Median / High Price $574.02 / $1,191.38 / $1,966.00	Facility		$574.02	$1,191.38	$1,966.00
United Facility/Professional Professional Modifier Low / Median / High Price $53.36 / $95.89 / $144.76	Professional		$53.36	$95.89	$144.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.20 / $83.20 / $97.90	Professional		$83.20	$83.20	$97.90