Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.92 / $54.45 / $75.80	Professional		$37.92	$54.45	$75.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.77 / $81.45 / $149.97	Professional		$54.77	$81.45	$149.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $65.95 / $112.32	Professional		$36.44	$65.95	$112.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.28 / $80.64 / $132.54	Facility		$47.28	$80.64	$132.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.02 / $108.98 / $254.90	Professional		$69.02	$108.98	$254.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $56.78 / $93.17 / $149.97	Facility		$56.78	$93.17	$149.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $62.60 / $93.17 / $149.97	Professional		$62.60	$93.17	$149.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.40 / $121.90 / $171.40	Professional		$83.40	$121.90	$171.40
United Facility/Professional Professional Modifier Low / Median / High Price $64.12 / $85.11 / $146.96	Professional		$64.12	$85.11	$146.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.80 / $66.40 / $105.80	Professional		$54.80	$66.40	$105.80