Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.22 / $110.00 / $137.74	Professional		$14.22	$110.00	$137.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $50.16 / $206.08	Professional		$19.00	$50.16	$206.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.36 / $163.51	Professional		$100.00	$117.36	$163.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.54 / $122.47 / $181.98	Facility		$39.54	$122.47	$181.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.82 / $195.31 / $806.50	Professional		$23.82	$195.31	$806.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $168.41 / $168.41 / $227.78	Facility		$168.41	$168.41	$227.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.82 / $168.41 / $233.95	Professional		$126.82	$168.41	$233.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.82 / $23.82 / $35.42	Professional		$23.82	$23.82	$35.42
United Facility/Professional Professional Modifier Low / Median / High Price $23.82 / $183.11 / $328.94	Professional		$23.82	$183.11	$328.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $29.80 / $29.80 / $29.80	Professional		$29.80	$29.80	$29.80