Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.44 / $76.67 / $103.73	Professional		$52.44	$76.67	$103.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.93 / $107.63 / $134.53	Professional		$43.93	$107.63	$134.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $91.53 / $100.91	Professional		$76.73	$91.53	$100.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.95 / $91.53 / $130.15	Facility		$67.95	$91.53	$130.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.22 / $45.66 / $91.32	Professional		$42.22	$45.66	$91.32
Midlands Facility/Professional Facility Modifier Low / Median / High Price $91.16 / $100.68 / $178.48	Facility		$91.16	$100.68	$178.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $82.46 / $100.00 / $178.48	Professional		$82.46	$100.00	$178.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $94.64 / $168.93	Professional		$35.00	$94.64	$168.93
United Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $45.66 / $58.47	Professional		$38.04	$45.66	$58.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $65.08 / $82.38 / $82.38	Professional		$65.08	$82.38	$82.38