Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.56 / $100.73 / $264.19	Facility		$75.56	$100.73	$264.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.56 / $99.71 / $144.01	Professional		$75.56	$99.71	$144.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.68 / $172.68 / $172.68	Facility		$172.68	$172.68	$172.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $130.03 / $260.10	Professional		$69.00	$130.03	$260.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $90.40 / $126.36 / $195.72	Professional		$90.40	$126.36	$195.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $98.81 / $119.27 / $186.36	Facility		$98.81	$119.27	$186.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.77 / $169.30 / $656.42	Professional		$91.77	$169.30	$656.42
Midlands Facility/Professional Facility Modifier Low / Median / High Price $118.50 / $137.18 / $211.11	Facility		$118.50	$137.18	$211.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $119.27 / $163.08 / $261.70	Professional		$119.27	$163.08	$261.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $108.02 / $188.16	Professional		$79.48	$108.02	$188.16
United Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $132.66 / $275.35	Professional		$79.48	$132.66	$275.35
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.90 / $118.26 / $149.69	Professional		$114.90	$118.26	$149.69