Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $135.44 / $199.00 / $334.40	Facility		$135.44	$199.00	$334.40
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $475.45 / $475.45 / $475.45	Facility	50	$475.45	$475.45	$475.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.19 / $79.59 / $237.50	Professional		$38.19	$79.59	$237.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.25 / $116.68 / $200.62	Professional		$84.25	$116.68	$200.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.21 / $92.48 / $188.65	Professional		$40.21	$92.48	$188.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.32 / $114.28 / $331.04	Facility		$63.32	$114.28	$331.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.63 / $122.94 / $489.67	Professional		$68.63	$122.94	$489.67
Midlands Facility/Professional Facility Modifier Low / Median / High Price $90.57 / $120.75 / $169.65	Facility		$90.57	$120.75	$169.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $120.75 / $172.13	Professional		$80.33	$120.75	$172.13
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,130.99 / $2,261.96 / $3,223.30	Facility		$1,130.99	$2,261.96	$3,223.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.89 / $75.59 / $133.10	Professional		$40.89	$75.59	$133.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,640.00 / $2,126.00	Facility		$1,204.00	$1,640.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $95.49 / $177.85	Professional		$62.40	$95.49	$177.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $78.90 / $92.90 / $157.00	Professional		$78.90	$92.90	$157.00