Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.05 / $292.44 / $409.06	Facility		$162.05	$292.44	$409.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.22 / $130.79 / $219.92	Professional		$99.22	$130.79	$219.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.55 / $273.52 / $341.90	Professional		$180.55	$273.52	$341.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.36 / $263.08 / $463.35	Professional		$165.36	$263.08	$463.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $150.33 / $194.00 / $384.84	Facility		$150.33	$194.00	$384.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.20 / $135.30 / $564.83	Professional		$90.20	$135.30	$564.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $180.40 / $210.46 / $329.46	Facility		$180.40	$210.46	$329.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $180.40 / $274.92 / $392.36	Professional		$180.40	$274.92	$392.36
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $410.98 / $410.98 / $410.98	Facility		$410.98	$410.98	$410.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $150.33 / $150.33 / $268.33	Professional		$150.33	$150.33	$268.33
United Facility/Professional Professional Modifier Low / Median / High Price $90.20 / $90.20 / $327.72	Professional		$90.20	$90.20	$327.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $150.33 / $150.33 / $150.33	Professional		$150.33	$150.33	$150.33