Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.74 / $80.50 / $94.62	Professional		$56.74	$80.50	$94.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.19 / $111.38 / $139.22	Professional		$46.19	$111.38	$139.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $96.22 / $112.51	Professional		$81.79	$96.22	$112.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.59 / $102.80 / $187.63	Facility		$80.59	$102.80	$187.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.38 / $48.01 / $96.01	Professional		$44.38	$48.01	$96.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.84 / $105.84 / $187.63	Facility		$95.84	$105.84	$187.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $86.69 / $95.84 / $187.63	Professional		$86.69	$95.84	$187.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $98.15 / $175.20	Professional		$50.00	$98.15	$175.20
United Facility/Professional Professional Modifier Low / Median / High Price $40.01 / $48.01 / $61.46	Professional		$40.01	$48.01	$61.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $68.41 / $86.60 / $86.60	Professional		$68.41	$86.60	$86.60