Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.12 / $62.24 / $70.22	Professional		$43.12	$62.24	$70.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.18 / $97.13 / $121.41	Professional		$30.18	$97.13	$121.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $62.88 / $79.45 / $92.42	Professional		$62.88	$79.45	$92.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $62.24 / $80.87 / $163.49	Facility		$62.24	$80.87	$163.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.37 / $41.83 / $71.80	Professional		$31.37	$41.83	$71.80
Midlands Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $92.22 / $163.49	Facility		$70.00	$92.22	$163.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $83.50 / $163.49	Professional		$70.00	$83.50	$163.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $85.52 / $152.65	Professional		$50.00	$85.52	$152.65
United Facility/Professional Professional Modifier Low / Median / High Price $26.14 / $41.83 / $53.56	Professional		$26.14	$41.83	$53.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $59.61 / $75.45 / $75.45	Professional		$59.61	$75.45	$75.45