Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.80 / $189.13 / $264.56	Facility		$104.80	$189.13	$264.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.17 / $84.58 / $94.30	Professional		$64.17	$84.58	$94.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.76 / $176.91 / $221.14	Professional		$116.76	$176.91	$221.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $121.53 / $170.14 / $599.94	Professional		$121.53	$170.14	$599.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.22 / $125.46 / $223.61	Facility		$97.22	$125.46	$223.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.33 / $97.22 / $381.63	Professional		$58.33	$97.22	$381.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $116.66 / $178.26 / $216.05	Facility		$116.66	$178.26	$216.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $116.66 / $178.26 / $247.91	Professional		$116.66	$178.26	$247.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.22 / $97.22 / $173.54	Professional		$97.22	$97.22	$173.54
United Facility/Professional Professional Modifier Low / Median / High Price $58.33 / $58.33 / $199.06	Professional		$58.33	$58.33	$199.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $97.22 / $97.22 / $97.22	Professional		$97.22	$97.22	$97.22