Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.67 / $263.00 / $385.50	Facility		$208.67	$263.00	$385.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.14 / $124.09 / $195.87	Professional		$94.14	$124.09	$195.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.29 / $259.16 / $323.95	Professional		$171.29	$259.16	$323.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $156.88 / $249.60 / $330.00	Professional		$156.88	$249.60	$330.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $184.06 / $365.13	Facility		$142.63	$184.06	$365.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.58 / $128.37 / $535.90	Professional		$85.58	$128.37	$535.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $171.16 / $199.68 / $312.58	Facility		$171.16	$199.68	$312.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $171.16 / $260.83 / $372.26	Professional		$171.16	$260.83	$372.26
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $282.99 / $282.99 / $282.99	Facility		$282.99	$282.99	$282.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $142.63 / $254.59	Professional		$142.63	$142.63	$254.59
United Facility/Professional Professional Modifier Low / Median / High Price $85.58 / $85.58 / $310.93	Professional		$85.58	$85.58	$310.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $142.63 / $142.63	Professional		$142.63	$142.63	$142.63