Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.33 / $2,352.00 / $6,066.00	Facility		$365.33	$2,352.00	$6,066.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.40 / $146.91 / $584.00	Professional		$84.40	$146.91	$584.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.26 / $225.94 / $357.41	Professional		$122.26	$225.94	$357.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $80.64 / $157.21 / $234.80	Professional		$80.64	$157.21	$234.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.84 / $202.92 / $1,607.00	Facility		$123.84	$202.92	$1,607.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.49 / $220.39 / $605.84	Professional		$138.49	$220.39	$605.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $178.31 / $250.42 / $394.19	Facility		$178.31	$250.42	$394.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $157.00 / $220.39 / $347.89	Professional		$157.00	$220.39	$347.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.92 / $137.16 / $233.41	Professional		$73.92	$137.16	$233.41
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 $132.81 / $198.23 / $403.46	Professional		$132.81	$198.23	$403.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $145.30 / $170.90 / $263.00	Professional		$145.30	$170.90	$263.00