Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $102.62 / $200.60	Facility		$51.31	$102.62	$200.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $80.00	Professional		$51.31	$51.31	$80.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.51 / $61.57 / $66.89	Professional		$53.51	$61.57	$66.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.44 / $89.79 / $132.90	Professional		$56.44	$89.79	$132.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $69.27 / $133.41	Facility		$51.31	$69.27	$133.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $51.31 / $174.79	Professional		$30.79	$51.31	$174.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $61.57 / $72.83 / $133.41	Facility		$61.57	$72.83	$133.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.57 / $84.37 / $133.87	Professional		$61.57	$84.37	$133.87
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $541.48 / $2,071.14 / $3,577.38	Facility		$541.48	$2,071.14	$3,577.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $91.59	Professional		$51.31	$51.31	$91.59
United Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $30.79 / $105.06	Professional		$30.79	$30.79	$105.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $51.31	Professional		$51.31	$51.31	$51.31