Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $294.86 / $388.26 / $401.81	Facility		$294.86	$388.26	$401.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.93 / $154.15 / $297.63	Professional		$98.93	$154.15	$297.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.04 / $276.58 / $371.05	Professional		$205.04	$276.58	$371.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $98.42 / $173.67 / $323.93	Professional		$98.42	$173.67	$323.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $140.94 / $265.47 / $661.20	Facility		$140.94	$265.47	$661.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $143.91 / $264.66 / $966.32	Professional		$143.91	$264.66	$966.32
Midlands Facility/Professional Facility Modifier Low / Median / High Price $102.65 / $245.22 / $338.38	Facility		$102.65	$245.22	$338.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $205.74 / $266.60 / $343.35	Professional		$205.74	$266.60	$343.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.77 / $159.69 / $238.46	Professional		$96.77	$159.69	$238.46
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 $135.62 / $204.85 / $403.36	Professional		$135.62	$204.85	$403.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $189.30 / $222.70 / $293.70	Professional		$189.30	$222.70	$293.70