Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $14.00 / $18.10	Professional		$14.00	$14.00	$18.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.32 / $63.25 / $81.37	Professional		$16.32	$63.25	$81.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $60.33 / $61.64	Professional		$36.40	$60.33	$61.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.00 / $14.70 / $52.17	Facility		$14.00	$14.70	$52.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.32 / $92.90 / $222.35	Professional		$45.32	$92.90	$222.35
Midlands Facility/Professional Facility Modifier Low / Median / High Price $52.17 / $52.17 / $60.44	Facility		$52.17	$52.17	$60.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $41.56 / $52.17 / $61.35	Professional		$41.56	$52.17	$61.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $44.45 / $44.45	Professional		$44.45	$44.45	$44.45
United Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $75.36 / $112.06	Professional		$44.45	$75.36	$112.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $38.20 / $38.20	Professional		$38.20	$38.20	$38.20