Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.52 / $190.52 / $359.06	Facility		$190.52	$190.52	$359.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $310.70	Professional		$164.25	$164.25	$310.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.13 / $164.25 / $217.20	Professional		$155.13	$164.25	$217.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $116.22 / $164.25 / $289.10	Professional		$116.22	$164.25	$289.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $163.21 / $182.80 / $275.82	Facility		$163.21	$182.80	$275.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $163.21 / $181.21 / $3,623.57	Professional		$163.21	$181.21	$3,623.57
Midlands Facility/Professional Facility Modifier Low / Median / High Price $182.73 / $228.77 / $283.86	Facility		$182.73	$228.77	$283.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $153.44 / $198.26 / $244.81	Professional		$153.44	$198.26	$244.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $325.49 / $343.10	Professional		$164.25	$325.49	$343.10
United Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $169.18 / $195.46	Professional		$164.25	$169.18	$195.46
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $178.60 / $178.60 / $178.60	Facility		$178.60	$178.60	$178.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.09 / $178.60 / $178.60	Professional		$141.09	$178.60	$178.60