Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.94 / $82.65 / $126.76	Professional		$47.94	$82.65	$126.76
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $75.45 / $275.00 / $277.89	Professional	25	$75.45	$275.00	$277.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.17 / $79.28 / $203.07	Professional		$41.17	$79.28	$203.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $37.63 / $80.11 / $121.43	Professional		$37.63	$80.11	$121.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.73 / $115.53 / $215.04	Facility		$52.73	$115.53	$215.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.07 / $108.70 / $329.60	Professional		$82.07	$108.70	$329.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $103.38 / $123.71 / $203.07	Facility		$103.38	$123.71	$203.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $101.01 / $132.11 / $218.50	Professional		$101.01	$132.11	$218.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $87.85 / $158.44	Professional		$42.98	$87.85	$158.44
United Facility/Professional Professional Modifier Low / Median / High Price $76.38 / $96.99 / $183.32	Professional		$76.38	$96.99	$183.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $107.30 / $191.40	Professional		$91.20	$107.30	$191.40