Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $15.49 / $147.91	Facility		$15.49	$15.49	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $15.49 / $173.78	Professional		$12.02	$15.49	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $107.15 / $134.90	Professional		$28.84	$107.15	$134.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $75.86 / $151.36	Professional		$66.07	$75.86	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $28.84 / $141.25	Facility		$15.49	$28.84	$141.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $12.88 / $89.13	Professional		$12.88	$12.88	$89.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $89.13 / $141.25	Professional		$15.49	$89.13	$141.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $97.72 / $97.72	Professional		$15.49	$97.72	$97.72
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Facility		$2,041.74	$2,041.74	$2,041.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $93.33 / $112.20	Professional		$83.18	$93.33	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
United Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $12.88 / $16.22	Professional		$12.88	$12.88	$16.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $12.88 / $12.88	Professional		$10.23	$12.88	$12.88