Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $295.12 / $436.52	Facility		$120.23	$295.12	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $125.89 / $154.88	Professional		$109.65	$125.89	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $302.00 / $380.19	Professional		$204.17	$302.00	$380.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $204.17 / $281.84	Professional		$131.83	$204.17	$281.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $186.21 / $363.08	Facility		$158.49	$186.21	$363.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $158.49 / $630.96	Professional		$93.33	$158.49	$630.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $204.17	Professional		$186.21	$186.21	$204.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $169.82 / $331.13	Professional		$158.49	$169.82	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $363.08	Facility		$158.49	$158.49	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $398.11	Professional		$93.33	$93.33	$398.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49