Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $52.20 / $52.20	Professional		$33.88	$52.20	$52.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $72.38 / $90.47	Professional		$61.00	$72.38	$90.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $52.58 / $62.32 / $112.80	Professional		$52.58	$62.32	$112.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.86 / $68.40 / $87.74	Facility		$49.86	$68.40	$87.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.50 / $39.82 / $161.15	Professional		$30.50	$39.82	$161.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $62.07 / $68.55 / $89.70	Facility		$62.07	$68.55	$89.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $55.23 / $71.23 / $102.44	Professional		$55.23	$71.23	$102.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.10 / $88.80 / $116.30	Professional		$44.10	$88.80	$116.30
United Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $31.09 / $53.37	Professional		$29.27	$31.09	$53.37
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $56.09 / $56.09 / $56.09	Facility		$56.09	$56.09	$56.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $44.31 / $56.09 / $56.09	Professional		$44.31	$56.09	$56.09