Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.69 / $71.59 / $86.00	Professional		$49.69	$71.59	$86.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $105.38 / $131.72	Professional		$41.03	$105.38	$131.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.66 / $85.48 / $99.94	Professional		$72.66	$85.48	$99.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.46 / $85.32 / $121.54	Facility		$63.46	$85.32	$121.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.43 / $42.65 / $85.30	Professional		$39.43	$42.65	$85.30
Midlands Facility/Professional Facility Modifier Low / Median / High Price $85.14 / $94.03 / $166.69	Facility		$85.14	$94.03	$166.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $76.12 / $85.14 / $166.69	Professional		$76.12	$85.14	$166.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $92.87 / $165.77	Professional		$35.00	$92.87	$165.77
United Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $42.65 / $57.11	Professional		$35.54	$42.65	$57.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $60.77 / $76.93 / $76.93	Professional		$60.77	$76.93	$76.93