Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.79 / $49.68 / $66.61	Professional		$42.79	$49.68	$66.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $60.46 / $114.41	Professional		$22.22	$60.46	$114.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $142.72 / $152.72 / $184.88	Professional		$142.72	$152.72	$184.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.42 / $66.61 / $243.96	Facility		$22.42	$66.61	$243.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.93 / $89.10 / $293.12	Professional		$49.93	$89.10	$293.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $60.46 / $89.01 / $119.42	Facility		$60.46	$89.01	$119.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $22.98 / $89.01 / $119.30	Professional		$22.98	$89.01	$119.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $66.00 / $66.00	Professional		$66.00	$66.00	$66.00
United Facility/Professional Professional Modifier Low / Median / High Price $47.76 / $82.36 / $126.49	Professional		$47.76	$82.36	$126.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $11.93 / $15.10 / $17.80	Professional		$11.93	$15.10	$17.80