Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $360.10 / $3,167.00 / $6,298.62	Facility		$360.10	$3,167.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.12 / $200.99 / $531.10	Professional		$120.12	$200.99	$531.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.23 / $363.09 / $502.52	Professional		$187.23	$363.09	$502.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $133.06 / $225.76 / $391.91	Professional		$133.06	$225.76	$391.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $185.39 / $335.82 / $2,969.00	Facility		$185.39	$335.82	$2,969.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $189.23 / $330.79 / $998.00	Professional		$189.23	$330.79	$998.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $181.75 / $300.39 / $430.85	Facility		$181.75	$300.39	$430.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $243.58 / $335.08 / $468.10	Professional		$243.58	$335.08	$468.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $127.22 / $227.09 / $316.07	Professional		$127.22	$227.09	$316.07
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 $177.72 / $242.34 / $430.78	Professional		$177.72	$242.34	$430.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $239.50 / $281.80 / $362.70	Professional		$239.50	$281.80	$362.70