Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $79.43 / $89.13	Professional		$47.86	$79.43	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $114.82 / $144.54	Professional		$45.71	$114.82	$144.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $95.50 / $117.49	Professional		$81.28	$95.50	$117.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $95.50 / $134.90	Facility		$79.43	$95.50	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $47.86 / $81.28	Professional		$38.90	$47.86	$81.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $186.21	Professional		$104.71	$186.21	$186.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $208.93	Professional		$97.72	$134.90	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $47.86 / $61.66	Professional		$37.15	$47.86	$61.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11