Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $175.02 / $240.76 / $501.88	Facility		$175.02	$240.76	$501.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.61 / $92.12 / $323.63	Professional		$58.61	$92.12	$323.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.76 / $167.51 / $238.60	Professional		$114.76	$167.51	$238.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.52 / $112.45 / $229.03	Professional		$58.52	$112.45	$229.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $90.17 / $156.13 / $661.20	Facility		$90.17	$156.13	$661.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.76 / $159.00 / $605.52	Professional		$85.76	$159.00	$605.52
Midlands Facility/Professional Facility Modifier Low / Median / High Price $82.67 / $151.27 / $209.13	Facility		$82.67	$151.27	$209.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $121.57 / $159.00 / $212.19	Professional		$121.57	$159.00	$212.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.92 / $104.64 / $154.40	Professional		$58.92	$104.64	$154.40
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 $78.30 / $119.31 / $235.93	Professional		$78.30	$119.31	$235.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.90 / $135.10 / $188.80	Professional		$114.90	$135.10	$188.80