Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.86 / $51.03 / $274.10	Professional		$35.86	$51.03	$274.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.20 / $97.71 / $133.83	Professional		$59.20	$97.71	$133.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $37.18 / $63.16 / $203.48	Professional		$37.18	$63.16	$203.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.57 / $98.01 / $245.00	Facility		$49.57	$98.01	$245.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.04 / $111.20 / $245.25	Professional		$66.04	$111.20	$245.25
Midlands Facility/Professional Facility Modifier Low / Median / High Price $82.75 / $104.49 / $123.64	Facility		$82.75	$104.49	$123.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.23 / $104.49 / $125.45	Professional		$75.23	$104.49	$125.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.90 / $63.60 / $97.75	Professional		$35.90	$63.60	$97.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,607.00 / $2,126.00	Facility		$1,204.00	$1,607.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $87.76 / $145.16	Professional		$60.34	$87.76	$145.16
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $80.09 / $94.20 / $120.90	Professional		$80.09	$94.20	$120.90