Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.33 / $87.12 / $99.64	Professional		$56.33	$87.12	$99.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.92 / $121.13 / $151.41	Professional		$49.92	$121.13	$151.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $88.41 / $104.01 / $123.90	Professional		$88.41	$104.01	$123.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.12 / $110.00 / $202.82	Facility		$87.12	$110.00	$202.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.98 / $51.89 / $103.78	Professional		$47.98	$51.89	$103.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $103.59 / $114.41 / $202.82	Facility		$103.59	$114.41	$202.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $92.16 / $103.59 / $202.82	Professional		$92.16	$103.59	$202.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $106.67 / $190.41	Professional		$50.00	$106.67	$190.41
United Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $51.89 / $89.07	Professional		$45.00	$51.89	$89.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.95 / $93.61 / $93.61	Professional		$73.95	$93.61	$93.61