Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.69 / $88.80 / $92.95	Professional		$59.69	$88.80	$92.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.89 / $123.00 / $153.75	Professional		$50.89	$123.00	$153.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $90.12 / $106.02 / $145.43	Professional		$90.12	$106.02	$145.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.52 / $106.02 / $206.74	Facility		$74.52	$106.02	$206.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $52.89 / $105.78	Professional		$48.90	$52.89	$105.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $105.59 / $116.62 / $206.74	Facility		$105.59	$116.62	$206.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.94 / $105.59 / $206.74	Professional		$93.94	$105.59	$206.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $108.14 / $193.03	Professional		$35.00	$108.14	$193.03
United Facility/Professional Professional Modifier Low / Median / High Price $43.56 / $52.89 / $67.72	Professional		$43.56	$52.89	$67.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.38 / $95.42 / $95.42	Professional		$75.38	$95.42	$95.42