Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.20 / $89.57 / $105.64	Professional		$55.20	$89.57	$105.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $146.25 / $182.81	Professional		$51.33	$146.25	$182.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $97.49 / $107.21 / $127.44	Professional		$97.49	$107.21	$127.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $86.51 / $114.77 / $208.53	Facility		$86.51	$114.77	$208.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.33 / $53.35 / $106.70	Professional		$49.33	$53.35	$106.70
Midlands Facility/Professional Facility Modifier Low / Median / High Price $106.51 / $117.63 / $208.53	Facility		$106.51	$117.63	$208.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $94.75 / $106.51 / $208.53	Professional		$94.75	$106.51	$208.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $128.65 / $229.64	Professional		$50.00	$128.65	$229.64
United Facility/Professional Professional Modifier Low / Median / High Price $44.46 / $53.35 / $68.31	Professional		$44.46	$53.35	$68.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $76.04 / $96.25 / $96.25	Professional		$76.04	$96.25	$96.25