Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.38 / $215.68 / $331.59	Facility		$133.38	$215.68	$331.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.96 / $84.07 / $215.68	Professional		$46.96	$84.07	$215.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.97 / $136.22 / $216.20	Professional		$94.97	$136.22	$216.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $49.69 / $101.75 / $210.48	Professional		$49.69	$101.75	$210.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $76.86 / $128.01 / $392.86	Facility		$76.86	$128.01	$392.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $76.28 / $136.22 / $498.82	Professional		$76.28	$136.22	$498.82
Midlands Facility/Professional Facility Modifier Low / Median / High Price $74.02 / $122.99 / $184.90	Facility		$74.02	$122.99	$184.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $101.00 / $132.11 / $187.61	Professional		$101.00	$132.11	$187.61
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $420.62 / $2,727.82 / $4,711.67	Facility		$420.62	$2,727.82	$4,711.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.07 / $91.52 / $142.78	Professional		$52.07	$91.52	$142.78
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 $69.65 / $106.13 / $197.66	Professional		$69.65	$106.13	$197.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $97.50 / $114.80 / $170.60	Professional		$97.50	$114.80	$170.60