Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.70 / $25.52 / $32.75	Professional		$23.70	$25.52	$32.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $37.50 / $39.78	Professional		$30.00	$37.50	$39.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $64.23 / $64.23 / $64.23	Professional		$64.23	$64.23	$64.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.14 / $145.13 / $145.13	Facility		$34.14	$145.13	$145.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $30.62 / $62.97	Professional		$26.80	$30.62	$62.97
Midlands Facility/Professional Facility Modifier Low / Median / High Price $34.14 / $39.78 / $63.03	Facility		$34.14	$39.78	$63.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $33.24 / $44.85 / $68.58	Professional		$33.24	$44.85	$68.58
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $5,870.21 / $5,870.21 / $5,870.21	Facility		$5,870.21	$5,870.21	$5,870.21
United Facility/Professional Professional Modifier Low / Median / High Price $25.99 / $29.06 / $42.21	Professional		$25.99	$29.06	$42.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1.00 / $1.00 / $1.00	Professional		$1.00	$1.00	$1.00