Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.29 / $30.89 / $121.62	Professional		$20.29	$30.89	$121.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.25 / $61.28 / $179.59	Professional		$17.25	$61.28	$179.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $15.84 / $76.72 / $115.43	Professional		$15.84	$76.72	$115.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.34 / $76.72 / $189.21	Facility		$22.34	$76.72	$189.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.89 / $94.61 / $318.27	Professional		$69.89	$94.61	$318.27
Midlands Facility/Professional Facility Modifier Low / Median / High Price $47.61 / $103.00 / $189.21	Facility		$47.61	$103.00	$189.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $43.74 / $110.95 / $208.07	Professional		$43.74	$110.95	$208.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.25 / $40.13 / $151.37	Professional		$18.25	$40.13	$151.37
United Facility/Professional Professional Modifier Low / Median / High Price $71.17 / $88.87 / $164.92	Professional		$71.17	$88.87	$164.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $45.00 / $185.60	Professional		$38.20	$45.00	$185.60