Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $338.84	Professional		$77.62	$91.20	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $131.83 / $204.17	Professional		$83.18	$131.83	$204.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $89.13 / $186.21	Professional		$39.81	$89.13	$186.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $123.03 / $190.55	Facility		$83.18	$123.03	$190.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $138.04 / $575.44	Professional		$81.28	$138.04	$575.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $218.78	Professional		$120.23	$151.36	$218.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $154.88	Professional		$107.15	$138.04	$154.88
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $426.58 / $1,412.54	Facility		$380.19	$426.58	$1,412.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $204.17	Professional		$81.28	$120.23	$204.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $102.33	Professional		$81.28	$102.33	$102.33