Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.17 / $125.17 / $166.29	Facility		$125.17	$125.17	$166.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.14 / $114.06 / $214.53	Professional		$74.14	$114.06	$214.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.53 / $116.53 / $220.78	Facility		$116.53	$116.53	$220.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.47 / $210.59 / $261.08	Professional		$168.47	$210.59	$261.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $171.13 / $181.82 / $200.71	Professional		$171.13	$181.82	$200.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.09 / $257.89 / $947.19	Facility		$126.09	$257.89	$947.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.87 / $103.87 / $263.27	Professional		$89.87	$103.87	$263.27
Midlands Facility/Professional Facility Modifier Low / Median / High Price $220.13 / $220.78 / $273.67	Facility		$220.13	$220.78	$273.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $188.00 / $257.89 / $421.92	Professional		$188.00	$257.89	$421.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $183.75 / $204.72 / $358.27	Professional		$183.75	$204.72	$358.27
United Facility/Professional Facility Modifier Low / Median / High Price $91.72 / $91.72 / $91.72	Facility		$91.72	$91.72	$91.72
United Facility/Professional Professional Modifier Low / Median / High Price $89.07 / $100.13 / $234.18	Professional		$89.07	$100.13	$234.18
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $196.70 / $196.70 / $196.70	Facility		$196.70	$196.70	$196.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $155.38 / $196.70 / $196.70	Professional		$155.38	$196.70	$196.70