Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.85 / $52.00 / $207.84	Facility		$29.85	$52.00	$207.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.00 / $118.92 / $177.60	Professional		$68.00	$118.92	$177.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $520.64 / $536.26 / $551.88	Facility		$520.64	$536.26	$551.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.15 / $223.98 / $485.20	Professional		$131.15	$223.98	$485.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $142.49 / $191.37 / $492.69	Professional		$142.49	$191.37	$492.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.50 / $267.45 / $540.39	Facility		$144.50	$267.45	$540.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.94 / $219.16 / $698.27	Professional		$137.94	$219.16	$698.27
Midlands Facility/Professional Facility Modifier Low / Median / High Price $235.05 / $275.57 / $551.88	Facility		$235.05	$275.57	$551.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $235.05 / $269.52 / $534.99	Professional		$235.05	$269.52	$534.99
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $162.34 / $1,213.80 / $2,470.96	Facility		$162.34	$1,213.80	$2,470.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.78 / $50.30 / $74.88	Professional		$22.78	$50.30	$74.88
United Facility/Professional Professional Modifier Low / Median / High Price $127.92 / $163.30 / $289.95	Professional		$127.92	$163.30	$289.95
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $247.82 / $313.70 / $369.00	Professional		$247.82	$313.70	$369.00