Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.14 / $177.31 / $177.31	Facility		$76.14	$177.31	$177.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.50 / $37.52 / $52.63	Professional		$27.50	$37.52	$52.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.07 / $67.00 / $89.16	Professional		$42.07	$67.00	$89.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $18.91 / $41.09 / $104.24	Professional		$18.91	$41.09	$104.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.34 / $70.92 / $152.54	Facility		$31.34	$70.92	$152.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $69.29 / $315.83	Professional		$34.72	$69.29	$315.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $40.75 / $63.32 / $91.76	Facility		$40.75	$63.32	$91.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $40.75 / $63.32 / $94.00	Professional		$40.75	$63.32	$94.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.66 / $30.68 / $52.75	Professional		$16.66	$30.68	$52.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,640.00 / $2,126.00	Facility		$1,204.00	$1,640.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $30.39 / $54.12 / $94.21	Professional		$30.39	$54.12	$94.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $35.90 / $42.30 / $65.70	Professional		$35.90	$42.30	$65.70