Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $52.48 / $61.66	Professional		$26.92	$52.48	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $89.13 / $112.20	Professional		$29.51	$89.13	$112.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $77.62	Professional		$52.48	$63.10	$77.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $61.66 / $87.10	Facility		$45.71	$61.66	$87.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $30.20 / $52.48	Professional		$24.55	$30.20	$52.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $120.23 / $120.23	Professional		$66.07	$120.23	$120.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $87.10 / $141.25	Professional		$63.10	$87.10	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $30.20 / $38.90	Professional		$23.99	$30.20	$38.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95