Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $79.43 / $100.00	Professional		$43.65	$79.43	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $128.82 / $158.49	Professional		$46.77	$128.82	$158.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $100.00 / $117.49	Professional		$85.11	$100.00	$117.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $100.00 / $144.54	Facility		$85.11	$100.00	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $50.12 / $87.10	Professional		$40.74	$50.12	$87.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $194.98 / $194.98	Professional		$102.33	$194.98	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $218.78	Professional		$102.33	$144.54	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $50.12 / $64.57	Professional		$40.74	$50.12	$64.57
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Professional		$91.20	$91.20	$91.20