Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.55 / $660.24 / $992.00	Facility		$107.55	$660.24	$992.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $401.40 / $692.46 / $1,107.00	Facility	25	$401.40	$692.46	$1,107.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.22 / $66.69 / $229.53	Professional		$53.22	$66.69	$229.53
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.18 / $125.70 / $304.00	Professional	25	$66.18	$125.70	$304.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $125.30 / $189.90	Professional		$65.06	$125.30	$189.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.41 / $96.66 / $279.07	Professional		$66.41	$96.66	$279.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.64 / $114.80 / $189.90	Facility		$63.64	$114.80	$189.90
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $211.14 / $234.73 / $286.55	Facility	25	$211.14	$234.73	$286.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $116.05 / $500.00	Professional		$69.00	$116.05	$500.00
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $69.00 / $130.74 / $141.35	Professional	25	$69.00	$130.74	$141.35
Midlands Facility/Professional Facility Modifier Low / Median / High Price $93.00 / $129.77 / $156.99	Facility		$93.00	$129.77	$156.99
Midlands Facility/Professional Professional Modifier Low / Median / High Price $88.45 / $124.85 / $163.90	Professional		$88.45	$124.85	$163.90
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $844.50 / $844.50 / $2,280.15	Facility		$844.50	$844.50	$2,280.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $118.54 / $134.77	Professional		$68.56	$118.54	$134.77
United Facility/Professional Professional Modifier Low / Median / High Price $65.87 / $93.67 / $145.66	Professional		$65.87	$93.67	$145.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $91.88 / $116.30 / $116.30	Professional		$91.88	$116.30	$116.30