Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.26 / $87.07 / $121.97	Professional		$68.26	$87.07	$121.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.66 / $143.25 / $179.06	Professional		$51.66	$143.25	$179.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.48 / $106.97 / $123.41	Professional		$91.48	$106.97	$123.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.07 / $115.46 / $209.86	Facility		$87.07	$115.46	$209.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.64 / $53.69 / $107.39	Professional		$49.64	$53.69	$107.39
Midlands Facility/Professional Facility Modifier Low / Median / High Price $107.19 / $118.38 / $209.86	Facility		$107.19	$118.38	$209.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $96.96 / $122.00 / $209.86	Professional		$96.96	$122.00	$209.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.62 / $125.88 / $224.70	Professional		$107.62	$125.88	$224.70
United Facility/Professional Professional Modifier Low / Median / High Price $44.75 / $53.69 / $68.75	Professional		$44.75	$53.69	$68.75
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $76.52 / $96.86 / $96.86	Professional		$76.52	$96.86	$96.86