Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.12 / $99.31 / $103.20	Professional		$80.12	$99.31	$103.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.28 / $150.38 / $187.97	Professional		$58.28	$150.38	$187.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.34 / $122.75 / $158.32	Professional		$104.34	$122.75	$158.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.81 / $129.72 / $239.36	Facility		$102.81	$129.72	$239.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.62 / $61.24 / $122.47	Professional		$56.62	$61.24	$122.47
Midlands Facility/Professional Facility Modifier Low / Median / High Price $122.25 / $135.03 / $239.36	Facility		$122.25	$135.03	$239.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $108.77 / $122.25 / $239.36	Professional		$108.77	$122.25	$239.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $132.32 / $236.19	Professional		$35.00	$132.32	$236.19
United Facility/Professional Professional Modifier Low / Median / High Price $48.37 / $61.24 / $78.41	Professional		$48.37	$61.24	$78.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $110.48 / $110.48	Professional		$87.28	$110.48	$110.48