Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.95 / $79.90 / $179.20	Facility		$44.95	$79.90	$179.20
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $72.76 / $72.76 / $346.08	Facility	25	$72.76	$72.76	$346.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.56 / $48.60 / $104.00	Professional		$26.56	$48.60	$104.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $34.86 / $58.95 / $145.00	Professional	25	$34.86	$58.95	$145.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.38 / $68.27 / $118.10	Professional		$35.38	$68.27	$118.10
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $61.05 / $102.97	Professional		$32.63	$61.05	$102.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.55 / $51.77 / $88.33	Facility		$31.55	$51.77	$88.33
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $99.33 / $99.33 / $99.33	Facility	62	$99.33	$99.33	$99.33
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $15.89 / $15.89 / $15.89	Facility	AS	$15.89	$15.89	$15.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $79.68 / $354.09	Professional		$46.00	$79.68	$354.09
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $62.63 / $103.01 / $147.47	Professional	25	$62.63	$103.01	$147.47
Midlands Facility/Professional Facility Modifier Low / Median / High Price $50.94 / $81.59 / $109.10	Facility		$50.94	$81.59	$109.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $48.41 / $68.33 / $109.10	Professional		$48.41	$68.33	$109.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $69.22 / $75.19 / $599.13	Facility		$69.22	$75.19	$599.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.72 / $60.21 / $102.85	Professional		$33.72	$60.21	$102.85
United Facility/Professional Professional Modifier Low / Median / High Price $44.15 / $61.93 / $99.01	Professional		$44.15	$61.93	$99.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $42.20 / $54.70 / $80.50	Professional		$42.20	$54.70	$80.50