Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $97.72 / $114.82	Professional		$54.95	$97.72	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $151.36 / $186.21	Professional		$58.88	$151.36	$186.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $165.96	Professional		$104.71	$123.03	$165.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $123.03 / $173.78	Facility		$100.00	$123.03	$173.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $61.66 / $104.71	Professional		$47.86	$61.66	$104.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $239.88 / $239.88	Professional		$125.89	$239.88	$239.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $269.15	Professional		$125.89	$173.78	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $61.66 / $77.62	Professional		$47.86	$61.66	$77.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65