Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.85 / $112.85 / $209.70	Facility		$112.85	$112.85	$209.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.76 / $75.33 / $110.37	Professional		$40.76	$75.33	$110.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.95 / $141.55 / $214.98	Professional		$74.95	$141.55	$214.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $72.22 / $243.34	Professional		$36.31	$72.22	$243.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.14 / $82.44 / $145.26	Facility		$42.14	$82.44	$145.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.37 / $192.02 / $513.01	Professional		$98.37	$192.02	$513.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $90.77 / $152.66 / $201.47	Facility		$90.77	$152.66	$201.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $90.77 / $152.66 / $214.98	Professional		$90.77	$152.66	$214.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $105.20 / $105.20 / $105.20	Professional		$105.20	$105.20	$105.20
United Facility/Professional Professional Modifier Low / Median / High Price $87.92 / $155.49 / $207.94	Professional		$87.92	$155.49	$207.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.20 / $141.40	Professional		$63.10	$77.20	$141.40