Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.69 / $29.34 / $80.95	Professional		$22.69	$29.34	$80.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.31 / $88.31 / $88.31	Professional		$88.31	$88.31	$88.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $115.71 / $139.38 / $167.44	Professional		$115.71	$139.38	$167.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.13 / $47.54 / $137.62	Facility		$28.13	$47.54	$137.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.79 / $162.19 / $380.66	Professional		$52.79	$162.19	$380.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $43.67 / $69.29 / $142.00	Facility		$43.67	$69.29	$142.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $96.78 / $157.86	Professional		$43.67	$96.78	$157.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.00 / $39.60 / $54.80	Professional		$31.00	$39.60	$54.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.31 / $92.80 / $92.80	Professional		$73.31	$92.80	$92.80