Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.38 / $176.64 / $293.64	Facility		$93.38	$176.64	$293.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.77 / $76.81 / $204.00	Professional		$65.77	$76.81	$204.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.78 / $127.69 / $159.61	Professional		$80.78	$127.69	$159.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $77.31 / $123.01 / $215.17	Professional		$77.31	$123.01	$215.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.93 / $91.38 / $179.94	Facility		$39.93	$91.38	$179.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.12 / $46.07 / $277.63	Professional		$41.12	$46.07	$277.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $39.93 / $97.61 / $179.94	Facility		$39.93	$97.61	$179.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $97.61 / $192.15	Professional		$39.93	$97.61	$192.15
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $180.07 / $2,911.11 / $5,028.27	Facility		$180.07	$2,911.11	$5,028.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.39 / $70.29 / $125.47	Professional		$68.39	$70.29	$125.47
United Facility/Professional Professional Modifier Low / Median / High Price $43.62 / $44.58 / $161.76	Professional		$43.62	$44.58	$161.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $70.29 / $70.29 / $70.29	Professional		$70.29	$70.29	$70.29