Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.30 / $67.30 / $84.31	Facility		$67.30	$67.30	$84.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $54.34 / $86.22	Professional		$44.88	$54.34	$86.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.05 / $75.05 / $75.05	Facility		$75.05	$75.05	$75.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.25 / $126.56 / $163.95	Professional		$101.25	$126.56	$163.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $152.85 / $157.19 / $168.15	Professional		$152.85	$157.19	$168.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.34 / $200.19 / $472.60	Facility		$54.34	$200.19	$472.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.37 / $68.16 / $199.50	Professional		$52.37	$68.16	$199.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $108.76 / $129.56 / $205.01	Facility		$108.76	$129.56	$205.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $108.23 / $163.95 / $223.34	Professional		$108.23	$163.95	$223.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $118.04 / $125.52 / $133.16	Professional		$118.04	$125.52	$133.16
United Facility/Professional Professional Modifier Low / Median / High Price $51.86 / $57.82 / $137.87	Professional		$51.86	$57.82	$137.87
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $326.89 / $326.89 / $326.89	Facility		$326.89	$326.89	$326.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $258.25 / $326.89 / $326.89	Professional		$258.25	$326.89	$326.89