Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $331.13 / $537.03	Facility		$213.80	$331.13	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $213.80 / $707.95	Professional		$38.02	$213.80	$707.95
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $295.12 / $489.78 / $549.54	Professional	QX	$295.12	$489.78	$549.54
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $295.12 / $309.03 / $489.78	Professional	QY	$295.12	$309.03	$489.78
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $436.52 / $436.52 / $436.52	Professional	QZ	$436.52	$436.52	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $371.54 / $457.09	Professional		$251.19	$371.54	$457.09
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $416.87 / $416.87 / $524.81	Professional	AA	$416.87	$416.87	$524.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $331.13 / $489.78	Professional		$251.19	$331.13	$489.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $3,388.44 / $4,786.30	Facility		$2,089.30	$3,388.44	$4,786.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $1,348.96	Professional		$44.67	$58.88	$1,348.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $22.39 / $46.77	Professional		$8.91	$22.39	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $83.18	Professional		$39.81	$54.95	$83.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $489.78	Professional		$380.19	$380.19	$489.78
Wellmark Facility/Professional Professional Modifier QX Low / Median / High Price $199.53 / $245.47 / $245.47	Professional	QX	$199.53	$245.47	$245.47