Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.61 / $73.31 / $100.46	Professional		$51.61	$73.31	$100.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.55 / $102.75 / $128.44	Professional		$42.55	$102.75	$128.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.22 / $88.10 / $103.65	Professional		$72.22	$88.10	$103.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $65.81 / $88.61 / $126.05	Facility		$65.81	$88.61	$126.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.88 / $44.22 / $88.44	Professional		$40.88	$44.22	$88.44
Midlands Facility/Professional Facility Modifier Low / Median / High Price $88.28 / $97.50 / $172.85	Facility		$88.28	$97.50	$172.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.84 / $95.00 / $172.85	Professional		$79.84	$95.00	$172.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $90.41 / $161.38	Professional		$35.00	$90.41	$161.38
United Facility/Professional Professional Modifier Low / Median / High Price $36.85 / $44.22 / $56.62	Professional		$36.85	$44.22	$56.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.03 / $79.78 / $79.78	Professional		$63.03	$79.78	$79.78