Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $554.16 / $2,352.00 / $6,298.62	Facility		$554.16	$2,352.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.65 / $291.67 / $862.28	Professional		$175.65	$291.67	$862.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.79 / $550.24 / $741.39	Professional		$272.79	$550.24	$741.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $176.72 / $334.63 / $560.20	Professional		$176.72	$334.63	$560.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $288.13 / $483.99 / $2,969.00	Facility		$288.13	$483.99	$2,969.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $292.33 / $501.72 / $1,435.68	Professional		$292.33	$501.72	$1,435.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $271.85 / $448.72 / $689.33	Facility		$271.85	$448.72	$689.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $373.00 / $501.72 / $741.39	Professional		$373.00	$501.72	$741.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $178.55 / $335.17 / $510.37	Professional		$178.55	$335.17	$510.37
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 $264.74 / $378.56 / $692.44	Professional		$264.74	$378.56	$692.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $345.10 / $405.90 / $584.50	Professional		$345.10	$405.90	$584.50