Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $45.87 / $48.99	Professional		$28.60	$45.87	$48.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.43 / $66.00 / $82.50	Professional		$24.43	$66.00	$82.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.36 / $56.35 / $64.40	Professional		$45.36	$56.35	$64.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.64 / $56.70 / $110.57	Facility		$44.64	$56.70	$110.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.40 / $28.29 / $56.00	Professional		$25.40	$28.29	$56.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $62.37 / $110.57	Facility		$56.00	$62.37	$110.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $56.48 / $110.57	Professional		$50.25	$56.48	$110.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.70 / $58.13 / $103.76	Professional		$56.70	$58.13	$103.76
United Facility/Professional Professional Modifier Low / Median / High Price $21.17 / $28.29 / $36.22	Professional		$21.17	$28.29	$36.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $40.31 / $51.03 / $51.03	Professional		$40.31	$51.03	$51.03