Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $176.76 / $1,300.33	Facility		$102.33	$176.76	$1,300.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.86 / $121.84 / $744.00	Professional		$81.86	$121.84	$744.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.25 / $128.25 / $160.31	Professional		$128.25	$128.25	$160.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $652.27 / $1,411.24	Professional		$150.00	$652.27	$1,411.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $167.47 / $364.36	Facility		$102.33	$167.47	$364.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $85.27 / $236.78	Professional		$85.27	$85.27	$236.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $167.67 / $175.21 / $374.71	Facility		$167.67	$175.21	$374.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.05 / $175.21 / $280.50	Professional		$117.05	$175.21	$280.50
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,250.47 / $7,386.21 / $10,795.23	Facility		$1,250.47	$7,386.21	$10,795.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $291.31 / $309.63 / $328.46	Professional		$291.31	$309.63	$328.46
United Facility/Professional Facility Modifier Low / Median / High Price $0.09 / $0.09 / $0.09	Facility		$0.09	$0.09	$0.09
United Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $85.27 / $93.80	Professional		$85.27	$85.27	$93.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $76.98 / $97.46 / $97.46	Professional		$76.98	$97.46	$97.46