Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $660.69 / $1,000.00	Facility		$117.49	$660.69	$1,000.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $407.38 / $691.83 / $1,071.52	Facility	25	$407.38	$691.83	$1,071.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $69.18 / $239.88	Professional		$52.48	$69.18	$239.88
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $63.10 / $138.04 / $331.13	Professional	25	$63.10	$138.04	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $125.89 / $194.98	Professional		$61.66	$125.89	$194.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $104.71 / $288.40	Professional		$67.61	$104.71	$288.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $107.15 / $208.93	Facility		$63.10	$107.15	$208.93
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $208.93 / $234.42 / $288.40	Facility	25	$208.93	$234.42	$288.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $112.20 / $501.19	Professional		$66.07	$112.20	$501.19
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $69.18 / $131.83 / $141.25	Professional	25	$69.18	$131.83	$141.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $165.96	Professional		$100.00	$131.83	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $134.90 / $190.55	Professional		$125.89	$134.90	$190.55
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $2,290.87	Facility		$851.14	$851.14	$2,290.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $165.96	Professional		$72.44	$128.82	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $741.31	Facility		$741.31	$741.31	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $144.54	Professional		$64.57	$85.11	$144.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $117.49	Professional		$97.72	$117.49	$117.49