Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $131.83 / $602.56	Facility		$23.99	$131.83	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $45.71 / $173.78	Professional		$10.96	$45.71	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $50.12 / $134.90	Professional		$13.80	$50.12	$134.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $58.88 / $134.90	Professional		$12.59	$58.88	$134.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $58.88 / $141.25	Facility		$14.13	$58.88	$141.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $89.13 / $323.59	Professional		$41.69	$89.13	$323.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $93.33 / $120.23	Professional		$20.89	$93.33	$120.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $70.79 / $138.04	Professional		$29.51	$70.79	$138.04
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $8,317.64 / $16,595.87	Facility		$3,090.30	$8,317.64	$16,595.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $47.86 / $109.65	Professional		$12.02	$47.86	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $44.67 / $112.20	Professional		$15.14	$44.67	$112.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $21.38 / $81.28	Professional		$16.98	$21.38	$81.28