Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $204.17 / $204.17	Facility		$162.18	$204.17	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $169.82 / $426.58	Professional		$162.18	$169.82	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $213.80	Professional		$173.78	$173.78	$213.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $295.12 / $346.74	Professional		$151.36	$295.12	$346.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $251.19	Facility		$169.82	$169.82	$251.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $204.17 / $354.81	Professional		$181.97	$204.17	$354.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $416.87 / $501.19	Professional		$371.54	$416.87	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $204.17 / $223.87	Professional		$194.98	$204.17	$223.87
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $169.82	Professional		$134.90	$169.82	$169.82