Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.74 / $95.74 / $185.97	Facility		$95.74	$95.74	$185.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $95.74	Professional		$84.57	$84.57	$95.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $122.96 / $170.61	Professional		$84.57	$122.96	$170.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $153.07 / $322.93	Professional		$84.57	$153.07	$322.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.53 / $95.74 / $180.33	Facility		$84.53	$95.74	$180.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $84.53 / $94.10 / $518.54	Professional		$84.53	$94.10	$518.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $139.72 / $176.45 / $219.63	Facility		$139.72	$176.45	$219.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.79 / $152.68 / $181.15	Professional		$126.79	$152.68	$181.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.11 / $167.59 / $176.66	Professional		$87.11	$167.59	$176.66
United Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $88.80 / $100.64	Professional		$84.57	$88.80	$100.64
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $92.50 / $92.50 / $92.50	Facility		$92.50	$92.50	$92.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.08 / $92.50 / $92.50	Professional		$73.08	$92.50	$92.50