Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.11 / $277.01 / $369.36	Facility		$24.11	$277.01	$369.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.41 / $203.77 / $566.01	Professional		$136.41	$203.77	$566.01
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $125.35 / $277.92 / $663.10	Professional	25	$125.35	$277.92	$663.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.85 / $323.63 / $494.33	Professional		$172.85	$323.63	$494.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $168.36 / $280.54 / $440.75	Professional		$168.36	$280.54	$440.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $160.47 / $271.95 / $408.13	Facility		$160.47	$271.95	$408.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $211.12 / $355.05 / $1,377.15	Professional		$211.12	$355.05	$1,377.15
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $325.16 / $325.16 / $638.78	Professional	25	$325.16	$325.16	$638.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $263.45 / $349.81 / $426.45	Facility		$263.45	$349.81	$426.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $259.64 / $345.54 / $426.45	Professional		$259.64	$345.54	$426.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $171.27 / $303.47 / $417.54	Professional		$171.27	$303.47	$417.54
United Facility/Professional Professional Modifier Low / Median / High Price $207.11 / $266.29 / $458.01	Professional		$207.11	$266.29	$458.01
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $88.00	Professional	25	$80.00	$80.00	$88.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $218.50 / $257.00 / $315.70	Professional		$218.50	$257.00	$315.70