Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.57 / $100.61 / $125.59	Professional		$62.57	$100.61	$125.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $146.25 / $182.81	Professional		$57.66	$146.25	$182.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.10 / $120.12 / $145.13	Professional		$102.10	$120.12	$145.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.18 / $128.25 / $234.23	Facility		$97.18	$128.25	$234.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.40 / $59.93 / $119.86	Professional		$55.40	$59.93	$119.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $119.64 / $132.13 / $234.23	Facility		$119.64	$132.13	$234.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $106.44 / $119.64 / $234.23	Professional		$106.44	$119.64	$234.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $128.72 / $229.77	Professional		$50.00	$128.72	$229.77
United Facility/Professional Professional Modifier Low / Median / High Price $46.92 / $59.93 / $76.73	Professional		$46.92	$59.93	$76.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.41 / $108.11 / $108.11	Professional		$85.41	$108.11	$108.11