Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.99 / $352.34 / $855.65	Facility		$168.99	$352.34	$855.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.36 / $161.43 / $531.00	Professional		$50.36	$161.43	$531.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.20 / $158.91 / $318.45	Professional		$119.20	$158.91	$318.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.15 / $153.04 / $336.98	Professional		$54.15	$153.04	$336.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $82.07 / $216.09 / $1,204.00	Facility		$82.07	$216.09	$1,204.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.65 / $214.00 / $499.00	Professional		$123.65	$214.00	$499.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $126.31 / $245.27 / $312.37	Facility		$126.31	$245.27	$312.37
Midlands Facility/Professional Professional Modifier Low / Median / High Price $121.55 / $214.00 / $304.17	Professional		$121.55	$214.00	$304.17
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $616.75 / $11,051.27 / $16,151.84	Facility		$616.75	$11,051.27	$16,151.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.31 / $109.72 / $226.20	Professional		$58.31	$109.72	$226.20
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 $118.50 / $154.56 / $285.11	Professional		$118.50	$154.56	$285.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $99.00 / $116.50 / $235.10	Professional		$99.00	$116.50	$235.10