Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $218.78 / $354.81	Facility		$144.54	$218.78	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $144.54 / $389.05	Professional		$34.67	$144.54	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $223.87 / $269.15	Professional		$151.36	$223.87	$269.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $218.78 / $323.59	Professional		$169.82	$218.78	$323.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $64.57 / $4,073.80	Facility		$57.54	$64.57	$4,073.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $891.25	Professional		$44.67	$58.88	$891.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.37 / $22.39 / $46.77	Professional		$5.37	$22.39	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $83.18	Professional		$39.81	$54.95	$83.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $331.13	Professional		$257.04	$257.04	$331.13