Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.07 / $105.07 / $201.96	Facility		$105.07	$105.07	$201.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.06 / $87.21 / $105.07	Professional		$84.06	$87.21	$105.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.38 / $89.31 / $94.22	Professional		$75.38	$89.31	$94.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.97 / $158.62 / $240.10	Professional		$141.97	$158.62	$240.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.06 / $105.07 / $144.47	Facility		$84.06	$105.07	$144.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $96.32 / $399.27	Professional		$87.56	$96.32	$399.27
Midlands Facility/Professional Facility Modifier Low / Median / High Price $118.21 / $144.47 / $209.53	Facility		$118.21	$144.47	$209.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $119.27 / $119.27 / $119.27	Professional		$119.27	$119.27	$119.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $27.40 / $27.40	Professional		$27.40	$27.40	$27.40
United Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $90.19 / $104.20	Professional		$87.56	$90.19	$104.20
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $101.57 / $101.57 / $101.57	Facility		$101.57	$101.57	$101.57
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $80.23 / $101.57 / $101.57	Professional		$80.23	$101.57	$101.57