Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.27 / $263.27 / $286.99	Facility		$263.27	$263.27	$286.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.59 / $128.34 / $143.09	Professional		$113.59	$128.34	$143.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.33 / $180.68 / $327.49	Professional		$169.33	$180.68	$327.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.52 / $258.16 / $463.53	Professional		$147.52	$258.16	$463.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $140.13 / $251.55 / $711.89	Facility		$140.13	$251.55	$711.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.52 / $265.54 / $1,213.06	Professional		$147.52	$265.54	$1,213.06
Midlands Facility/Professional Facility Modifier Low / Median / High Price $190.36 / $265.54 / $372.00	Facility		$190.36	$265.54	$372.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $191.78 / $300.54 / $424.96	Professional		$191.78	$300.54	$424.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $143.54 / $147.52 / $263.32	Professional		$143.54	$147.52	$263.32
United Facility/Professional Professional Modifier Low / Median / High Price $147.52 / $147.52 / $357.80	Professional		$147.52	$147.52	$357.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $147.52 / $147.52 / $147.52	Professional		$147.52	$147.52	$147.52