Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.60 / $85.64 / $174.15	Professional		$63.60	$85.64	$174.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $113.78 / $217.65	Professional		$69.00	$113.78	$217.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $65.04 / $90.29 / $221.40	Professional		$65.04	$90.29	$221.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.58 / $113.61 / $185.03	Facility		$72.58	$113.61	$185.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.83 / $201.56 / $555.30	Professional		$93.83	$201.56	$555.30
Midlands Facility/Professional Facility Modifier Low / Median / High Price $161.91 / $172.20 / $218.23	Facility		$161.91	$172.20	$218.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $161.91 / $176.72 / $224.58	Professional		$161.91	$176.72	$224.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.72 / $98.72 / $152.06	Professional		$73.72	$98.72	$152.06
United Facility/Professional Professional Modifier Low / Median / High Price $85.61 / $144.19 / $238.51	Professional		$85.61	$144.19	$238.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $121.90 / $139.30 / $163.80	Professional		$121.90	$139.30	$163.80