Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $100.00 / $125.89	Professional		$61.66	$100.00	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $147.91 / $181.97	Professional		$57.54	$147.91	$181.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $120.23 / $144.54	Professional		$102.33	$120.23	$144.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $123.03 / $169.82	Facility		$89.13	$123.03	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $60.26 / $102.33	Professional		$47.86	$60.26	$102.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $234.42 / $234.42	Professional		$123.03	$234.42	$234.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $263.03	Professional		$123.03	$169.82	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $75.86	Professional		$46.77	$60.26	$75.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Professional		$107.15	$107.15	$107.15