Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $44.67 / $50.12	Professional		$22.91	$44.67	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $66.07 / $83.18	Professional		$25.12	$66.07	$83.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $52.48 / $58.88	Professional		$43.65	$52.48	$58.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $51.29 / $74.13	Facility		$38.90	$51.29	$74.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.70 / $44.67	Professional		$21.38	$25.70	$44.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $102.33 / $102.33	Professional		$57.54	$102.33	$102.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $74.13 / $112.20	Professional		$52.48	$74.13	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Facility		$52.48	$52.48	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.70 / $33.11	Professional		$20.42	$25.70	$33.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Professional		$46.77	$46.77	$46.77