Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $3,090.30 / $6,025.60	Facility		$489.78	$3,090.30	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $537.03 / $3,090.30	Professional		$154.88	$537.03	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $457.09 / $1,445.44	Professional		$371.54	$457.09	$1,445.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $630.96 / $1,862.09	Professional		$151.36	$630.96	$1,862.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $1,348.96 / $5,011.87	Facility		$380.19	$1,348.96	$5,011.87
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $144.54 / $144.54 / $144.54	Facility	53	$144.54	$144.54	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $1,148.15 / $1,995.26	Professional		$436.52	$1,148.15	$1,995.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $1,071.52 / $1,479.11	Professional		$354.81	$1,071.52	$1,479.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $1,548.82	Professional		$436.52	$436.52	$1,548.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $457.09 / $1,023.29	Professional		$147.91	$457.09	$1,023.29
United Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,677.35 / $6,309.57	Facility		$2,570.40	$4,677.35	$6,309.57
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $575.44 / $1,548.82	Professional		$204.17	$575.44	$1,548.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $338.84 / $1,023.29	Professional		$288.40	$338.84	$1,023.29