Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.50 / $47.50 / $52.67	Professional		$47.50	$47.50	$52.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.75 / $23.44 / $29.52	Professional		$18.75	$23.44	$29.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.05 / $66.65 / $96.71	Professional		$45.05	$66.65	$96.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.67 / $69.02 / $85.03	Facility		$52.67	$69.02	$85.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $83.04 / $144.50	Professional		$55.00	$83.04	$144.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $60.05 / $60.05 / $60.05	Facility		$60.05	$60.05	$60.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $60.05 / $60.05 / $60.05	Professional		$60.05	$60.05	$60.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $92.00 / $120.00	Professional		$60.00	$92.00	$120.00
United Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $80.00 / $136.00	Professional		$55.00	$80.00	$136.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $35.79 / $35.79	Professional		$28.28	$35.79	$35.79