Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $231.36 / $417.53 / $683.48	Facility		$231.36	$417.53	$683.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.65 / $186.72 / $208.18	Professional		$141.65	$186.72	$208.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.54 / $389.72 / $487.15	Professional		$257.54	$389.72	$487.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $214.62 / $354.12 / $824.77	Professional		$214.62	$354.12	$824.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $214.62 / $276.95 / $500.53	Facility		$214.62	$276.95	$500.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.77 / $214.62 / $851.62	Professional		$128.77	$214.62	$851.62
Midlands Facility/Professional Facility Modifier Low / Median / High Price $257.54 / $357.42 / $470.36	Facility		$257.54	$357.42	$470.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $257.54 / $387.42 / $471.77	Professional		$257.54	$387.42	$471.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $214.62 / $214.62 / $383.10	Professional		$214.62	$214.62	$383.10
United Facility/Professional Professional Modifier Low / Median / High Price $128.77 / $128.77 / $449.28	Professional		$128.77	$128.77	$449.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $214.62 / $214.62 / $214.62	Professional		$214.62	$214.62	$214.62