Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $144.54	Facility		$120.23	$120.23	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $104.71 / $169.82	Professional		$81.28	$104.71	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $218.78	Facility		$112.20	$112.20	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $223.87 / $281.84	Professional		$112.20	$223.87	$281.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $204.17 / $223.87	Professional		$165.96	$204.17	$223.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $229.09 / $912.01	Facility		$131.83	$229.09	$912.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $323.59	Professional		$87.10	$117.49	$323.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $223.87 / $263.03	Professional		$213.80	$223.87	$263.03
Midlands Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Facility		$218.78	$218.78	$218.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $323.59 / $323.59	Professional		$199.53	$323.59	$323.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $426.58	Professional		$199.53	$257.04	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $144.54 / $281.84	Facility		$67.61	$144.54	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $97.72 / $177.83	Professional		$87.10	$97.72	$177.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $190.55	Professional		$151.36	$190.55	$190.55