Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.19 / $2,218.00 / $6,298.62	Facility		$87.19	$2,218.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.89 / $127.09 / $127.09	Professional		$45.89	$127.09	$127.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.50 / $185.63 / $384.70	Professional		$148.50	$185.63	$384.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $146.85 / $160.02 / $2,120.25	Professional		$146.85	$160.02	$2,120.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.40 / $227.49 / $2,108.82	Facility		$51.40	$227.49	$2,108.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.80 / $317.67 / $437.16	Professional		$151.80	$317.67	$437.16
Midlands Facility/Professional Facility Modifier Low / Median / High Price $484.29 / $646.00 / $753.33	Facility		$484.29	$646.00	$753.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $157.49 / $317.67 / $437.16	Professional		$157.49	$317.67	$437.16
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $387.19 / $387.19 / $387.19	Facility		$387.19	$387.19	$387.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,775.00 / $3,482.00 / $5,454.00	Facility		$1,775.00	$3,482.00	$5,454.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $182.02 / $230.40 / $271.10	Professional		$182.02	$230.40	$271.10