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 / $145.82	Professional		$99.22	$130.79	$145.82
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 / $239.97 / $272.10	Professional		$165.36	$239.97	$272.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $150.33 / $180.55 / $345.76	Facility		$150.33	$180.55	$345.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.20 / $150.33 / $485.13	Professional		$90.20	$150.33	$485.13
Midlands Facility/Professional Facility Modifier Low / Median / High Price $180.40 / $275.64 / $334.09	Facility		$180.40	$275.64	$334.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $180.40 / $275.64 / $350.27	Professional		$180.40	$275.64	$350.27
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