Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.07 / $171.58 / $239.99	Facility		$95.07	$171.58	$239.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.40 / $67.91 / $102.49	Professional		$58.40	$67.91	$102.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.49 / $133.16 / $203.61	Professional		$83.49	$133.16	$203.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $78.70 / $119.78 / $199.63	Professional		$78.70	$119.78	$199.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.91 / $97.72 / $207.38	Facility		$67.91	$97.72	$207.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.35 / $56.29 / $629.27	Professional		$39.35	$56.29	$629.27
Midlands Facility/Professional Facility Modifier Low / Median / High Price $82.54 / $172.58 / $253.84	Facility		$82.54	$172.58	$253.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $82.54 / $152.00 / $230.86	Professional		$82.54	$152.00	$230.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.80 / $97.80 / $97.80	Professional		$97.80	$97.80	$97.80
United Facility/Professional Facility Modifier Low / Median / High Price $50.76 / $50.76 / $50.76	Facility		$50.76	$50.76	$50.76
United Facility/Professional Professional Modifier Low / Median / High Price $39.35 / $56.17 / $117.03	Professional		$39.35	$56.17	$117.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $76.00 / $96.20 / $113.10	Professional		$76.00	$96.20	$113.10