Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.81 / $415.25 / $855.65	Facility		$170.81	$415.25	$855.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.56 / $170.82 / $591.00	Professional		$54.56	$170.82	$591.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.21 / $157.77 / $324.30	Professional		$126.21	$157.77	$324.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $57.13 / $155.99 / $353.72	Professional		$57.13	$155.99	$353.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.39 / $217.22 / $1,204.00	Facility		$87.39	$217.22	$1,204.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $124.12 / $213.38 / $499.00	Professional		$124.12	$213.38	$499.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $128.09 / $246.73 / $311.42	Facility		$128.09	$246.73	$311.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.09 / $214.81 / $307.45	Professional		$128.09	$214.81	$307.45
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $147.61 / $1,463.70 / $2,139.23	Facility		$147.61	$1,463.70	$2,139.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.45 / $115.54 / $224.50	Professional		$61.45	$115.54	$224.50
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 $120.24 / $155.15 / $286.19	Professional		$120.24	$155.15	$286.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $104.30 / $122.80 / $239.20	Professional		$104.30	$122.80	$239.20