Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.06 / $617.54 / $690.00	Facility		$106.06	$617.54	$690.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $442.00 / $997.50 / $997.50	Facility	25	$442.00	$997.50	$997.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.91 / $115.39 / $461.25	Professional		$93.91	$115.39	$461.25
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $105.70 / $370.26 / $1,110.78	Professional	25	$105.70	$370.26	$1,110.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.11 / $194.74 / $289.61	Professional		$102.11	$194.74	$289.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $102.01 / $163.77 / $286.91	Professional		$102.01	$163.77	$286.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.05 / $166.12 / $236.78	Facility		$95.05	$166.12	$236.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $129.94 / $212.63 / $1,183.50	Professional		$129.94	$212.63	$1,183.50
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $156.19 / $156.19 / $156.19	Professional	25	$156.19	$156.19	$156.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $154.29 / $211.03 / $282.10	Facility		$154.29	$211.03	$282.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $154.29 / $208.11 / $282.10	Professional		$154.29	$208.11	$282.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,224.96 / $8,161.03 / $22,034.73	Facility		$1,224.96	$8,161.03	$22,034.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $106.60 / $189.71 / $227.54	Professional		$106.60	$189.71	$227.54
United Facility/Professional Professional Modifier Low / Median / High Price $124.04 / $165.18 / $274.30	Professional		$124.04	$165.18	$274.30
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $144.66	Professional	25	$80.00	$80.00	$144.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $159.30 / $187.40 / $210.30	Professional		$159.30	$187.40	$210.30