Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.20 / $41.33 / $216.48	Professional		$33.20	$41.33	$216.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $60.00 / $74.91	Professional		$48.00	$60.00	$74.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $41.81 / $97.02	Professional		$35.54	$41.81	$97.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.84 / $74.91 / $100.89	Facility		$49.84	$74.91	$100.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.60 / $74.91 / $260.01	Professional		$51.60	$74.91	$260.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $54.26 / $66.84 / $102.28	Facility		$54.26	$66.84	$102.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $54.26 / $67.18 / $102.72	Professional		$54.26	$67.18	$102.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $79.40 / $101.90	Professional		$76.09	$79.40	$101.90
United Facility/Professional Professional Modifier Low / Median / High Price $45.03 / $65.50 / $110.13	Professional		$45.03	$65.50	$110.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $86.70 / $106.10	Professional		$68.48	$86.70	$106.10