Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $60.26 / $81.28	Professional		$53.70	$60.26	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $69.18 / $144.54	Professional		$39.81	$69.18	$144.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $66.07 / $162.18	Professional		$47.86	$66.07	$162.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $81.28 / $138.04	Facility		$52.48	$81.28	$138.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $138.04 / $407.38	Professional		$81.28	$138.04	$407.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $151.36	Professional		$85.11	$128.82	$151.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $112.20 / $158.49	Professional		$61.66	$112.20	$158.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $109.65 / $131.83	Professional		$93.33	$109.65	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $102.33 / $162.18	Professional		$66.07	$102.33	$162.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $75.86 / $83.18	Professional		$63.10	$75.86	$83.18