Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.20 / $56.88 / $205.00	Professional		$42.20	$56.88	$205.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.59 / $76.09 / $105.69	Professional		$52.59	$76.09	$105.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.33 / $91.30 / $150.00	Professional		$72.33	$91.30	$150.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $60.26 / $164.59	Professional		$43.99	$60.26	$164.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.93 / $103.66 / $147.69	Professional		$69.93	$103.66	$147.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.75 / $90.89 / $124.83	Professional		$65.75	$90.89	$124.83
United Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $59.55 / $87.51	Professional		$43.99	$59.55	$87.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $89.50 / $89.50 / $105.30	Professional		$89.50	$89.50	$105.30