Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $61.66 / $85.11	Professional		$45.71	$61.66	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $102.33 / $173.78	Professional		$57.54	$102.33	$173.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $100.00 / $204.17	Professional		$60.26	$100.00	$204.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $67.61 / $309.03	Facility		$43.65	$67.61	$309.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $162.18 / $524.81	Professional		$79.43	$162.18	$524.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $208.93	Professional		$104.71	$147.91	$208.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $104.71 / $117.49	Professional		$93.33	$104.71	$117.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $95.50 / $151.36	Professional		$61.66	$95.50	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $91.20 / $194.98	Professional		$46.77	$91.20	$194.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $102.33 / $125.89	Professional		$83.18	$102.33	$125.89