Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $56.23 / $134.90	Professional		$47.86	$56.23	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $114.82 / $144.54	Professional		$53.70	$114.82	$144.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $79.43 / $138.04	Professional		$51.29	$79.43	$138.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $97.72 / $346.74	Professional		$52.48	$97.72	$346.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $144.54	Professional		$85.11	$114.82	$144.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $112.20 / $144.54	Professional		$56.23	$112.20	$144.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $102.33 / $131.83	Professional		$56.23	$102.33	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $141.25	Professional		$52.48	$79.43	$141.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $104.71 / $125.89	Professional		$83.18	$104.71	$125.89