Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.45 / $401.24 / $5,549.00	Facility		$69.45	$401.24	$5,549.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.42 / $86.26 / $229.12	Professional		$53.42	$86.26	$229.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.90 / $149.19 / $199.64	Professional		$75.90	$149.19	$199.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.17 / $90.50 / $165.07	Professional		$54.17	$90.50	$165.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.95 / $138.54 / $1,341.00	Facility		$73.95	$138.54	$1,341.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.12 / $413.28	Professional		$70.79	$123.12	$413.28
Midlands Facility/Professional Facility Modifier Low / Median / High Price $110.44 / $139.41 / $173.47	Facility		$110.44	$139.41	$173.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.47 / $139.41 / $175.76	Professional		$100.47	$139.41	$175.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.15 / $89.52 / $123.40	Professional		$50.15	$89.52	$123.40
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 $67.72 / $92.34 / $184.68	Professional		$67.72	$92.34	$184.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $95.99 / $115.80 / $143.00	Professional		$95.99	$115.80	$143.00