Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $870.96 / $2,137.96	Facility		$186.21	$870.96	$2,137.96
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $416.87 / $912.01 / $2,041.74	Facility	25	$416.87	$912.01	$2,041.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $123.03 / $436.52	Professional		$87.10	$123.03	$436.52
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $95.50 / $186.21 / $549.54	Professional	25	$95.50	$186.21	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $218.78 / $323.59	Professional		$109.65	$218.78	$323.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $467.74	Professional		$114.82	$177.83	$467.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $177.83 / $295.12	Facility		$107.15	$177.83	$295.12
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $316.23 / $316.23 / $891.25	Facility	25	$316.23	$316.23	$891.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $213.80 / $741.31	Professional		$123.03	$213.80	$741.31
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $177.83 / $234.42 / $295.12	Professional	25	$177.83	$234.42	$295.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $281.84	Professional		$173.78	$223.87	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $323.59 / $616.60	Professional		$223.87	$323.59	$616.60
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $3,235.94	Facility		$1,202.26	$1,202.26	$3,235.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $204.17 / $281.84	Professional		$123.03	$204.17	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $151.36 / $269.15	Professional		$117.49	$151.36	$269.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $199.53	Professional		$169.82	$199.53	$199.53