Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $57.67 / $57.67	Professional		$57.67	$57.67	$57.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.13 / $12.66 / $204.33	Professional		$10.13	$12.66	$204.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $286.80 / $330.00	Professional		$150.00	$286.80	$330.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $128.60 / $198.11	Facility		$57.67	$128.60	$198.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.92 / $62.92 / $156.35	Professional		$62.92	$62.92	$156.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $144.74 / $150.16 / $150.16	Professional		$144.74	$150.16	$150.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.90 / $51.90 / $56.80	Professional		$51.90	$51.90	$56.80
United Facility/Professional Professional Modifier Low / Median / High Price $62.92 / $62.92 / $108.01	Professional		$62.92	$62.92	$108.01
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $22.10 / $22.10 / $22.10	Facility		$22.10	$22.10	$22.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $17.46 / $22.10 / $22.10	Professional		$17.46	$22.10	$22.10