Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.45 / $43.07 / $56.68	Professional		$38.45	$43.07	$56.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $65.00	Facility		$65.00	$65.00	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.66 / $102.16 / $169.77	Professional		$43.66	$102.16	$169.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $37.22 / $54.39 / $206.93	Professional		$37.22	$54.39	$206.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.18 / $92.23 / $114.59	Facility		$57.18	$92.23	$114.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.72 / $92.89 / $255.15	Professional		$51.72	$92.89	$255.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $77.20 / $92.89 / $113.14	Facility		$77.20	$92.89	$113.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $63.40 / $86.47 / $108.37	Professional		$63.40	$86.47	$108.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $64.45 / $76.23	Professional		$37.07	$64.45	$76.23
United Facility/Professional Professional Modifier Low / Median / High Price $43.77 / $73.79 / $109.92	Professional		$43.77	$73.79	$109.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.27 / $68.70 / $80.80	Professional		$54.27	$68.70	$80.80