Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $100.00 / $346.74	Professional		$51.29	$100.00	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $218.78 / $275.42	Professional		$169.82	$218.78	$275.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $346.74	Professional		$87.10	$134.90	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $138.04 / $489.78	Professional		$72.44	$138.04	$489.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $416.87	Professional		$131.83	$186.21	$416.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $234.42	Professional		$213.80	$213.80	$234.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $95.50 / $186.21	Professional		$85.11	$95.50	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $165.96	Professional		$72.44	$95.50	$165.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $199.53	Professional		$134.90	$169.82	$199.53