Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.19 / $419.63 / $2,301.00	Facility		$151.19	$419.63	$2,301.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.12 / $141.15 / $467.85	Professional		$52.12	$141.15	$467.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.61 / $120.76 / $268.79	Professional		$96.61	$120.76	$268.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.54 / $127.44 / $301.73	Professional		$41.54	$127.44	$301.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $202.59 / $1,026.00	Facility		$66.70	$202.59	$1,026.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.59 / $190.67 / $413.00	Professional		$101.59	$190.67	$413.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $102.16 / $202.61 / $255.71	Facility		$102.16	$202.61	$255.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.52 / $177.59 / $255.71	Professional		$97.52	$177.59	$255.71
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $262.42 / $2,336.51 / $3,414.89	Facility		$262.42	$2,336.51	$3,414.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.54 / $88.05 / $183.41	Professional		$46.54	$88.05	$183.41
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,623.00 / $2,126.00	Facility		$1,204.00	$1,623.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $97.36 / $133.41 / $253.98	Professional		$97.36	$133.41	$253.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $93.50 / $196.70	Professional		$79.40	$93.50	$196.70