Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.29 / $275.77 / $1,205.46	Facility		$106.29	$275.77	$1,205.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.48 / $267.93 / $745.60	Professional		$102.48	$267.93	$745.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.38 / $147.38 / $184.22	Professional		$147.38	$147.38	$184.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $150.00 / $543.50	Professional		$134.66	$150.00	$543.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.09 / $175.16 / $277.19	Facility		$107.09	$175.16	$277.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $180.23 / $450.58 / $617.29	Professional		$180.23	$450.58	$617.29
Midlands Facility/Professional Facility Modifier Low / Median / High Price $141.97 / $175.84 / $277.19	Facility		$141.97	$175.84	$277.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.03 / $175.84 / $277.19	Professional		$126.03	$175.84	$277.19
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,244.59 / $5,315.54 / $7,768.88	Facility		$1,244.59	$5,315.54	$7,768.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $349.11 / $371.40 / $394.04	Professional		$349.11	$371.40	$394.04
United Facility/Professional Professional Modifier Low / Median / High Price $450.58 / $450.58 / $784.64	Professional		$450.58	$450.58	$784.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $197.50 / $250.00 / $250.00	Professional		$197.50	$250.00	$250.00