Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.45 / $161.41 / $433.84	Facility		$79.45	$161.41	$433.84
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $74.52 / $233.02 / $858.27	Facility	25	$74.52	$233.02	$858.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.40 / $114.22 / $275.00	Professional		$48.40	$114.22	$275.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $55.91 / $120.50 / $275.17	Professional	25	$55.91	$120.50	$275.17
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $287.60 / $287.60 / $287.60	Professional	50	$287.60	$287.60	$287.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.57 / $173.03 / $252.40	Professional		$87.57	$173.03	$252.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $90.08 / $146.57 / $242.00	Professional		$90.08	$146.57	$242.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $86.90 / $142.18 / $214.97	Facility		$86.90	$142.18	$214.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.95 / $192.10 / $801.06	Professional		$111.95	$192.10	$801.06
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $150.19 / $213.79 / $285.58	Professional	25	$150.19	$213.79	$285.58
Midlands Facility/Professional Facility Modifier Low / Median / High Price $138.00 / $187.77 / $248.95	Facility		$138.00	$187.77	$248.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $127.13 / $187.77 / $248.95	Professional		$127.13	$187.77	$248.95
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $109.17 / $109.17 / $933.66	Facility		$109.17	$109.17	$933.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.99 / $158.56 / $236.39	Professional		$88.99	$158.56	$236.39
United Facility/Professional Professional Modifier Low / Median / High Price $99.86 / $138.04 / $239.82	Professional		$99.86	$138.04	$239.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $116.70 / $144.72 / $183.20	Professional		$116.70	$144.72	$183.20