Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.24 / $261.83 / $464.16	Facility		$153.24	$261.83	$464.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.87 / $99.42 / $132.24	Professional		$87.87	$99.42	$132.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.08 / $115.13 / $174.38	Professional		$78.08	$115.13	$174.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $242.55 / $289.12 / $734.50	Professional		$242.55	$289.12	$734.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.54 / $132.24 / $218.06	Facility		$85.54	$132.24	$218.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.69 / $169.74 / $745.59	Professional		$100.69	$169.74	$745.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $115.13 / $137.79 / $218.06	Facility		$115.13	$137.79	$218.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $113.08 / $154.62 / $218.06	Professional		$113.08	$154.62	$218.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $84.90 / $144.96 / $156.90	Professional		$84.90	$144.96	$156.90
United Facility/Professional Professional Modifier Low / Median / High Price $92.96 / $148.74 / $250.06	Professional		$92.96	$148.74	$250.06