Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.28 / $86.09 / $109.60	Professional		$57.28	$86.09	$109.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.33 / $126.75 / $158.44	Professional		$49.33	$126.75	$158.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.38 / $102.78 / $123.90	Professional		$87.38	$102.78	$123.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $86.09 / $109.69 / $200.42	Facility		$86.09	$109.69	$200.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.41 / $51.28 / $102.55	Professional		$47.41	$51.28	$102.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $102.36 / $113.06 / $200.42	Facility		$102.36	$113.06	$200.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.07 / $102.36 / $200.42	Professional		$91.07	$102.36	$200.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $111.41 / $198.87	Professional		$50.00	$111.41	$198.87
United Facility/Professional Professional Modifier Low / Median / High Price $40.95 / $51.28 / $85.46	Professional		$40.95	$51.28	$85.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.08 / $92.50 / $92.50	Professional		$73.08	$92.50	$92.50