Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.30 / $80.13 / $149.47	Professional		$50.30	$80.13	$149.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $101.02 / $244.30	Professional		$43.67	$101.02	$244.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $92.97 / $142.25	Professional		$38.29	$92.97	$142.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.15 / $128.10 / $378.45	Professional		$95.15	$128.10	$378.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.75 / $152.38 / $253.97	Professional		$109.75	$152.38	$253.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.80 / $93.20 / $181.01	Professional		$42.80	$93.20	$181.01
United Facility/Professional Professional Modifier Low / Median / High Price $94.85 / $114.82 / $203.98	Professional		$94.85	$114.82	$203.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $92.40 / $108.80 / $221.10	Professional		$92.40	$108.80	$221.10