Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.77 / $114.55 / $31,587.10	Facility		$70.77	$114.55	$31,587.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $66.97 / $33,168.44	Professional		$60.29	$66.97	$33,168.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.23 / $72.23 / $72.23	Facility		$72.23	$72.23	$72.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $65.41 / $84.99	Professional		$60.29	$65.41	$84.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.04 / $70.59 / $135.40	Professional		$44.04	$70.59	$135.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.56 / $70.77 / $98.97	Facility		$58.56	$70.77	$98.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.56 / $65.19 / $2,460.12	Professional		$58.56	$65.19	$2,460.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $70.77 / $87.84 / $115.20	Facility		$70.77	$87.84	$115.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.77 / $74.88 / $128.16	Professional		$70.77	$74.88	$128.16
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $13,072.78 / $31,519.20 / $89,829.80	Facility		$13,072.78	$31,519.20	$89,829.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $119.47 / $125.94	Professional		$60.29	$119.47	$125.94
United Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $63.91 / $80.05	Professional		$60.29	$63.91	$80.05
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $64.09 / $64.09 / $64.09	Facility		$64.09	$64.09	$64.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $50.63 / $64.09 / $64.09	Professional		$50.63	$64.09	$64.09