Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $267.10 / $814.00 / $6,066.00	Facility		$267.10	$814.00	$6,066.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.86 / $232.94 / $900.00	Professional		$109.86	$232.94	$900.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.45 / $283.77 / $497.65	Professional		$199.45	$283.77	$497.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.38 / $238.73 / $569.83	Professional		$91.38	$238.73	$569.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $140.58 / $358.40 / $1,341.00	Facility		$140.58	$358.40	$1,341.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $191.68 / $319.45 / $699.51	Professional		$191.68	$319.45	$699.51
Midlands Facility/Professional Facility Modifier Low / Median / High Price $217.57 / $375.18 / $503.82	Facility		$217.57	$375.18	$503.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $205.25 / $324.80 / $473.80	Professional		$205.25	$324.80	$473.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $99.89 / $191.16 / $441.58	Professional		$99.89	$191.16	$441.58
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,623.00 / $2,126.00	Facility		$1,204.00	$1,623.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $183.69 / $254.53 / $441.97	Professional		$183.69	$254.53	$441.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $167.20 / $196.70 / $370.40	Professional		$167.20	$196.70	$370.40