Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.98 / $115.20 / $167.75	Professional		$88.98	$115.20	$167.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.00 / $151.83 / $301.45	Professional		$93.00	$151.83	$301.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.42 / $128.56 / $330.00	Professional		$95.42	$128.56	$330.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.68 / $154.08 / $258.33	Facility		$104.68	$154.08	$258.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.43 / $265.31 / $747.63	Professional		$125.43	$265.31	$747.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $212.68 / $226.40 / $286.08	Facility		$212.68	$226.40	$286.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $212.68 / $232.04 / $311.06	Professional		$212.68	$232.04	$311.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.33 / $129.79 / $219.52	Professional		$104.33	$129.79	$219.52
United Facility/Professional Professional Modifier Low / Median / High Price $116.58 / $188.26 / $320.04	Professional		$116.58	$188.26	$320.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $178.40 / $197.50 / $232.30	Professional		$178.40	$197.50	$232.30