Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.34 / $143.44 / $636.29	Facility		$57.34	$143.44	$636.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.68 / $62.65 / $298.64	Professional		$36.68	$62.65	$298.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $86.17 / $107.71	Professional		$54.52	$86.17	$107.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $47.63 / $83.35 / $184.15	Professional		$47.63	$83.35	$184.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.63 / $76.79 / $230.13	Facility		$47.63	$76.79	$230.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $47.63 / $120.46	Professional		$28.58	$47.63	$120.46
Midlands Facility/Professional Facility Modifier Low / Median / High Price $61.47 / $97.06 / $149.32	Facility		$61.47	$97.06	$149.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $57.20 / $97.06 / $129.68	Professional		$57.20	$97.06	$129.68
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $251.01 / $2,672.53 / $4,616.17	Facility		$251.01	$2,672.53	$4,616.17
United Facility/Professional Professional Modifier Low / Median / High Price $28.58 / $31.76 / $109.55	Professional		$28.58	$31.76	$109.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $37.63 / $47.63 / $47.63	Professional		$37.63	$47.63	$47.63