Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.12 / $1,300.00 / $6,298.62	Facility		$162.12	$1,300.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.73 / $196.05 / $563.64	Professional		$71.73	$196.05	$563.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.55 / $156.79 / $447.01	Professional		$87.55	$156.79	$447.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $60.44 / $178.82 / $320.64	Professional		$60.44	$178.82	$320.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $85.33 / $235.70 / $3,482.00	Facility		$85.33	$235.70	$3,482.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.52 / $249.54 / $549.32	Professional		$140.52	$249.54	$549.32
Midlands Facility/Professional Facility Modifier Low / Median / High Price $139.40 / $200.88 / $395.12	Facility		$139.40	$200.88	$395.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.01 / $266.88 / $429.49	Professional		$123.01	$266.88	$429.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.90 / $142.62 / $277.66	Professional		$51.90	$142.62	$277.66
United Facility/Professional Facility Modifier Low / Median / High Price $1,775.00 / $3,522.00 / $5,454.00	Facility		$1,775.00	$3,522.00	$5,454.00
United Facility/Professional Professional Modifier Low / Median / High Price $163.22 / $216.56 / $401.22	Professional		$163.22	$216.56	$401.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $100.20 / $117.90 / $320.20	Professional		$100.20	$117.90	$320.20