Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.14 / $81.76 / $92.50	Professional		$72.14	$81.76	$92.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.82 / $127.88 / $159.84	Professional		$46.82	$127.88	$159.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.90 / $101.06 / $118.58	Professional		$85.90	$101.06	$118.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.65 / $107.92 / $197.07	Facility		$84.65	$107.92	$197.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.61 / $50.42 / $100.84	Professional		$46.61	$50.42	$100.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $100.65 / $111.17 / $197.07	Facility		$100.65	$111.17	$197.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.55 / $100.65 / $197.07	Professional		$89.55	$100.65	$197.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.06 / $112.64 / $201.06	Professional		$101.06	$112.64	$201.06
United Facility/Professional Professional Modifier Low / Median / High Price $40.56 / $50.42 / $73.95	Professional		$40.56	$50.42	$73.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $71.84 / $90.95 / $90.95	Professional		$71.84	$90.95	$90.95