Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.77 / $92.77 / $235.60	Facility		$92.77	$92.77	$235.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.71 / $13,477.20	Professional		$62.10	$62.71	$13,477.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $64.80 / $94.49	Professional		$62.10	$64.80	$94.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.59 / $100.02 / $204.06	Professional		$56.59	$100.02	$204.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.39 / $83.04 / $110.63	Facility		$63.39	$83.04	$110.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.39 / $70.56 / $282.02	Professional		$63.39	$70.56	$282.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $75.59 / $97.01 / $130.75	Facility		$75.59	$97.01	$130.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $92.33 / $99.91	Professional		$75.59	$92.33	$99.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $123.27 / $132.22	Professional		$62.10	$123.27	$132.22
United Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $65.83 / $88.12	Professional		$62.10	$65.83	$88.12
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $69.37 / $69.37 / $69.37	Facility		$69.37	$69.37	$69.37
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.80 / $69.37 / $69.37	Professional		$54.80	$69.37	$69.37