Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.56 / $2,352.00 / $6,298.62	Facility		$203.56	$2,352.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.04 / $146.59 / $806.93	Professional		$88.04	$146.59	$806.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.43 / $196.72 / $329.17	Professional		$112.43	$196.72	$329.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.11 / $141.61 / $213.82	Professional		$70.11	$141.61	$213.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.14 / $181.07 / $1,607.00	Facility		$107.14	$181.07	$1,607.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $124.63 / $192.15 / $525.44	Professional		$124.63	$192.15	$525.44
Midlands Facility/Professional Facility Modifier Low / Median / High Price $155.75 / $218.15 / $346.68	Facility		$155.75	$218.15	$346.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $140.11 / $192.15 / $320.56	Professional		$140.11	$192.15	$320.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $122.77 / $215.31	Professional		$65.56	$122.77	$215.31
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 $120.01 / $169.95 / $335.10	Professional		$120.01	$169.95	$335.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $126.90 / $149.30 / $242.00	Professional		$126.90	$149.30	$242.00