Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $91.20 / $173.78	Facility		$53.70	$91.20	$173.78
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	25	$213.80	$213.80	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.62 / $199.53	Professional		$40.74	$77.62	$199.53
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $56.23 / $109.65 / $251.19	Professional	25	$56.23	$109.65	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $83.18 / $169.82	Professional		$47.86	$83.18	$169.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $89.13 / $141.25	Professional		$44.67	$89.13	$141.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $69.18 / $134.90	Facility		$41.69	$69.18	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $109.65 / $457.09	Professional		$67.61	$109.65	$457.09
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $79.43 / $107.15 / $218.78	Professional	25	$79.43	$107.15	$218.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $117.49 / $169.82	Professional		$77.62	$117.49	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $213.80	Professional		$70.79	$123.03	$213.80
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $91.20 / $616.60	Facility		$83.18	$91.20	$616.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $79.43 / $154.88	Professional		$43.65	$79.43	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $91.20	Facility		$61.66	$61.66	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $77.62 / $131.83	Professional		$51.29	$77.62	$131.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $72.44 / $102.33	Professional		$56.23	$72.44	$102.33