Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.09 / $56.64 / $226.11	Professional		$51.09	$56.64	$226.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.77 / $118.90 / $174.43	Professional		$61.77	$118.90	$174.43
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.59 / $88.20 / $200.62	Professional		$58.59	$88.20	$200.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.51 / $91.29 / $134.84	Facility		$56.51	$91.29	$134.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.47 / $110.79 / $404.24	Professional		$71.47	$110.79	$404.24
Midlands Facility/Professional Facility Modifier Low / Median / High Price $91.22 / $123.13 / $170.23	Facility		$91.22	$123.13	$170.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.22 / $120.26 / $170.23	Professional		$91.22	$120.26	$170.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.70 / $118.30 / $161.10	Professional		$79.70	$118.30	$161.10
United Facility/Professional Professional Modifier Low / Median / High Price $68.22 / $95.89 / $154.25	Professional		$68.22	$95.89	$154.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $99.78 / $126.30 / $126.30	Professional		$99.78	$126.30	$126.30