Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.87 / $119.95 / $152.72	Professional		$88.87	$119.95	$152.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.73 / $166.13 / $207.66	Professional		$68.73	$166.13	$207.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $121.73 / $143.21 / $190.95	Professional		$121.73	$143.21	$190.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $111.61 / $152.96 / $279.26	Facility		$111.61	$152.96	$279.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $71.45 / $140.00	Professional		$66.06	$71.45	$140.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $157.53 / $279.26	Facility		$140.00	$157.53	$279.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.91 / $142.63 / $279.26	Professional		$126.91	$142.63	$279.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $146.08 / $260.75	Professional		$50.00	$146.08	$260.75
United Facility/Professional Professional Modifier Low / Median / High Price $57.06 / $71.45 / $91.49	Professional		$57.06	$71.45	$91.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $101.82 / $128.88 / $128.88	Professional		$101.82	$128.88	$128.88