Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $3,019.95 / $5,370.32	Facility		$602.56	$3,019.95	$5,370.32
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,090.30 / $3,090.30 / $7,244.36	Facility	50	$3,090.30	$3,090.30	$7,244.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $512.86 / $3,019.95	Professional		$144.54	$512.86	$3,019.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $436.52 / $1,445.44	Professional		$346.74	$436.52	$1,445.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $575.44 / $1,174.90	Professional		$151.36	$575.44	$1,174.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $1,318.26 / $5,011.87	Facility		$371.54	$1,318.26	$5,011.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $1,148.15 / $1,995.26	Professional		$407.38	$1,148.15	$1,995.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $1,047.13 / $1,445.44	Professional		$331.13	$1,047.13	$1,445.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $416.87 / $1,548.82	Professional		$407.38	$416.87	$1,548.82
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,884.03 / $8,128.31	Facility		$1,737.80	$2,884.03	$8,128.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $436.52 / $977.24	Professional		$141.25	$436.52	$977.24
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 $190.55 / $537.03 / $1,548.82	Professional		$190.55	$537.03	$1,548.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $1,000.00	Professional		$269.15	$316.23	$1,000.00