Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $199.53 / $263.03	Facility		$144.54	$199.53	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $323.59	Professional		$70.79	$109.65	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $120.23 / $218.78	Professional		$83.18	$120.23	$218.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $162.18 / $416.87	Professional		$85.11	$162.18	$416.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $128.82 / $223.87	Facility		$87.10	$128.82	$223.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $181.97 / $741.31	Professional		$112.20	$181.97	$741.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $194.98 / $223.87	Professional		$165.96	$194.98	$223.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $213.80 / $363.08	Professional		$154.88	$213.80	$363.08
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $45.71 / $489.78	Facility		$45.71	$45.71	$489.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $251.19	Professional		$85.11	$117.49	$251.19
United Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $151.36	Facility		$120.23	$120.23	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $223.87	Professional		$95.50	$134.90	$223.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $158.49	Professional		$100.00	$128.82	$158.49