Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $616.60 / $2,089.30	Facility		$269.15	$616.60	$2,089.30
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,071.52 / $1,819.70 / $3,467.37	Facility	25	$1,071.52	$1,819.70	$3,467.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $239.88 / $954.99	Professional		$173.78	$239.88	$954.99
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $190.55 / $323.59 / $1,174.90	Professional	25	$190.55	$323.59	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $354.81 / $602.56	Professional		$204.17	$354.81	$602.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $354.81 / $1,258.93	Professional		$204.17	$354.81	$1,258.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $316.23 / $512.86	Facility		$186.21	$316.23	$512.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $446.68 / $1,737.80	Professional		$275.42	$446.68	$1,737.80
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $309.03 / $426.58 / $524.81	Professional	25	$309.03	$426.58	$524.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $436.52 / $645.65	Professional		$346.74	$436.52	$645.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $537.03 / $741.31	Professional		$316.23	$537.03	$741.31
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $9,772.37 / $26,302.68	Facility		$1,348.96	$9,772.37	$26,302.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $380.19 / $660.69	Professional		$213.80	$380.19	$660.69
United Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility		$2,238.72	$2,238.72	$2,238.72
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $309.03 / $524.81	Professional		$229.09	$309.03	$524.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $380.19 / $478.63	Professional		$316.23	$380.19	$478.63