Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $2,290.87 / $7,943.28	Facility		$138.04	$2,290.87	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $67.61 / $245.47	Professional		$40.74	$67.61	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $109.65 / $123.03	Professional		$100.00	$109.65	$123.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $77.62 / $154.88	Professional		$43.65	$77.62	$154.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $114.82 / $1,949.84	Facility		$91.20	$114.82	$1,949.84
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	53	$50.12	$50.12	$50.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $104.71 / $186.21	Professional		$53.70	$104.71	$186.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $190.55	Professional		$93.33	$114.82	$190.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $109.65	Professional		$97.72	$97.72	$109.65
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $25,703.96 / $34,673.69	Facility		$3,162.28	$25,703.96	$34,673.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $74.13 / $95.50	Professional		$41.69	$74.13	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,621.81 / $3,548.13	Facility		$1,148.15	$1,621.81	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $81.28 / $144.54	Professional		$50.12	$81.28	$144.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $87.10 / $102.33	Professional		$67.61	$87.10	$102.33