Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $57.54 / $64.57	Professional		$33.11	$57.54	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $85.11 / $107.15	Professional		$33.11	$85.11	$107.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $69.18 / $83.18	Professional		$58.88	$69.18	$83.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $69.18 / $97.72	Facility		$51.29	$69.18	$97.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.88 / $58.88	Professional		$28.18	$33.88	$58.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $134.90 / $134.90	Professional		$72.44	$134.90	$134.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $147.91	Professional		$69.18	$97.72	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.88 / $43.65	Professional		$26.92	$33.88	$43.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66