Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.86 / $100.86 / $101.32	Facility		$100.86	$100.86	$101.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.46 / $63.97 / $244.32	Professional		$59.46	$63.97	$244.32
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $113.16 / $213.18 / $250.80	Professional	25	$113.16	$213.18	$250.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.23 / $128.07 / $159.31	Professional		$69.23	$128.07	$159.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $68.64 / $102.51 / $211.06	Professional		$68.64	$102.51	$211.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.33 / $82.15 / $142.43	Facility		$60.33	$82.15	$142.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.42 / $132.85 / $450.62	Professional		$79.42	$132.85	$450.62
Midlands Facility/Professional Facility Modifier Low / Median / High Price $102.86 / $136.66 / $189.66	Facility		$102.86	$136.66	$189.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.86 / $135.44 / $143.63	Professional		$102.86	$135.44	$143.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $116.76 / $133.60	Professional		$65.41	$116.76	$133.60
United Facility/Professional Professional Modifier Low / Median / High Price $75.81 / $97.47 / $167.65	Professional		$75.81	$97.47	$167.65
United Facility/Professional Professional Modifier 25 Low / Median / High Price $94.07 / $94.07 / $94.07	Professional	25	$94.07	$94.07	$94.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.63 / $100.30 / $100.80	Professional		$79.63	$100.30	$100.80