Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $159.74 / $333.75 / $437.87	Facility		$159.74	$333.75	$437.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $148.38 / $270.99	Professional		$142.63	$148.38	$270.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.29 / $259.02 / $323.79	Professional		$171.29	$259.02	$323.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $235.34 / $281.50	Professional		$150.00	$235.34	$281.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $184.06 / $328.05	Facility		$142.63	$184.06	$328.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $142.63 / $538.12	Professional		$86.29	$142.63	$538.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $171.16 / $199.68 / $312.58	Facility		$171.16	$199.68	$312.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $171.16 / $236.71 / $372.47	Professional		$171.16	$236.71	$372.47
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,399.87 / $12,399.80 / $21,417.83	Facility		$1,399.87	$12,399.80	$21,417.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.78 / $142.63 / $254.59	Professional		$138.78	$142.63	$254.59
United Facility/Professional Professional Modifier Low / Median / High Price $86.42 / $86.84 / $313.52	Professional		$86.42	$86.84	$313.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $142.63 / $142.63	Professional		$142.63	$142.63	$142.63