Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $77.06 / $77.97	Professional		$75.00	$77.06	$77.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.38 / $112.97 / $136.83	Professional		$90.38	$112.97	$136.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $108.71 / $115.71 / $150.00	Professional		$108.71	$115.71	$150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.06 / $119.03 / $231.89	Facility		$77.06	$119.03	$231.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.24 / $76.03 / $555.50	Professional		$58.24	$76.03	$555.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $98.11 / $115.28 / $193.24	Facility		$98.11	$115.28	$193.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $98.11 / $118.23 / $231.89	Professional		$98.11	$118.23	$231.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.80 / $51.80 / $51.80	Professional		$51.80	$51.80	$51.80
United Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $59.38 / $101.93	Professional		$54.90	$59.38	$101.93
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $107.13 / $107.13 / $107.13	Facility		$107.13	$107.13	$107.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $84.63 / $107.13 / $107.13	Professional		$84.63	$107.13	$107.13