Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $87.10 / $109.65	Professional		$52.48	$87.10	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $125.89 / $158.49	Professional		$48.98	$125.89	$158.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $123.03	Professional		$87.10	$102.33	$123.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $107.15 / $144.54	Facility		$85.11	$107.15	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $87.10	Professional		$40.74	$51.29	$87.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $199.53 / $199.53	Professional		$107.15	$199.53	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $223.87	Professional		$104.71	$147.91	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $66.07	Professional		$39.81	$51.29	$66.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33