Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $707.95	Facility		$102.33	$102.33	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $138.04 / $776.25	Professional		$81.28	$138.04	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $158.49	Professional		$128.82	$158.49	$158.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $257.04 / $776.25	Professional		$151.36	$257.04	$776.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $165.96 / $371.54	Facility		$102.33	$165.96	$371.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $257.04	Professional		$85.11	$85.11	$257.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $234.42 / $371.54	Professional		$117.49	$234.42	$371.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $263.03 / $263.03	Professional		$117.49	$263.03	$263.03
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $7,943.28 / $10,715.19	Facility		$1,348.96	$7,943.28	$10,715.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $309.03 / $363.08	Professional		$269.15	$309.03	$363.08
United Facility/Professional Facility Modifier Low / Median / High Price $0.09 / $0.09 / $263.03	Facility		$0.09	$0.09	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $102.33	Professional		$85.11	$85.11	$102.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $97.72 / $97.72	Professional		$77.62	$97.72	$97.72