Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.72 / $2,218.00 / $6,066.00	Facility		$189.72	$2,218.00	$6,066.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $187.00 / $441.56	Professional		$56.10	$187.00	$441.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.45 / $301.30 / $627.17	Professional		$124.45	$301.30	$627.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $56.99 / $277.97 / $460.40	Professional		$56.99	$277.97	$460.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $101.95 / $390.65 / $3,416.04	Facility		$101.95	$390.65	$3,416.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $211.88 / $461.60 / $1,617.12	Professional		$211.88	$461.60	$1,617.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $137.05 / $505.41 / $1,311.70	Facility		$137.05	$505.41	$1,311.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $124.45 / $406.56 / $620.12	Professional		$124.45	$406.56	$620.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.78 / $194.88 / $1,421.20	Professional		$54.78	$194.88	$1,421.20
United Facility/Professional Facility Modifier Low / Median / High Price $3,044.00 / $4,663.00 / $7,305.00	Facility		$3,044.00	$4,663.00	$7,305.00
United Facility/Professional Professional Modifier Low / Median / High Price $234.18 / $406.79 / $726.03	Professional		$234.18	$406.79	$726.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.70 / $129.10 / $481.70	Professional		$109.70	$129.10	$481.70