Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $68.56 / $99.25	Professional		$63.00	$68.56	$99.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.05 / $112.04 / $176.07	Professional		$41.05	$112.04	$176.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.70 / $63.52 / $95.40	Professional		$26.70	$63.52	$95.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.05 / $81.44 / $158.47	Professional		$41.05	$81.44	$158.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.05 / $112.04 / $176.07	Professional		$41.05	$112.04	$176.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $118.67 / $136.21	Professional		$66.48	$118.67	$136.21
United Facility/Professional Professional Modifier Low / Median / High Price $53.12 / $81.44 / $135.02	Professional		$53.12	$81.44	$135.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $99.54 / $126.00 / $131.00	Professional		$99.54	$126.00	$131.00