Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $467.74 / $812.83	Facility		$128.82	$467.74	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $812.83	Professional		$199.53	$257.04	$812.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $575.44 / $724.44	Professional		$389.05	$575.44	$724.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $549.54 / $933.25	Professional		$331.13	$549.54	$933.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $363.08 / $691.83	Facility		$302.00	$363.08	$691.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $309.03 / $1,202.26	Professional		$181.97	$309.03	$1,202.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $389.05	Professional		$363.08	$363.08	$389.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Facility		$1,071.52	$1,071.52	$1,071.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $323.59 / $645.65	Professional		$302.00	$323.59	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $691.83	Facility		$302.00	$302.00	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $758.58	Professional		$181.97	$181.97	$758.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00