Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.90 / $335.23 / $6,066.00	Facility		$153.90	$335.23	$6,066.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.94 / $158.68 / $537.66	Professional		$72.94	$158.68	$537.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.32 / $255.47 / $330.14	Professional		$122.32	$255.47	$330.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.08 / $163.77 / $424.20	Professional		$56.08	$163.77	$424.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $86.52 / $236.35 / $1,204.00	Facility		$86.52	$236.35	$1,204.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $129.12 / $233.92 / $585.00	Professional		$129.12	$233.92	$585.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $132.35 / $255.47 / $326.00	Facility		$132.35	$255.47	$326.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.91 / $235.00 / $318.27	Professional		$125.91	$235.00	$318.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.97 / $114.85 / $230.58	Professional		$60.97	$114.85	$230.58
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 $123.03 / $172.16 / $316.86	Professional		$123.03	$172.16	$316.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $102.60 / $120.70 / $244.80	Professional		$102.60	$120.70	$244.80