Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $226.00 / $2,912.34 / $7,119.04	Facility		$226.00	$2,912.34	$7,119.04
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $772.80 / $772.80 / $772.80	Facility	50	$772.80	$772.80	$772.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.67 / $95.19 / $312.00	Professional		$53.67	$95.19	$312.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $111.18 / $241.70 / $598.50	Professional	50	$111.18	$241.70	$598.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.61 / $157.77 / $236.65	Professional		$108.61	$157.77	$236.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $55.07 / $113.61 / $234.58	Professional		$55.07	$113.61	$234.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.92 / $149.88 / $734.94	Facility		$84.92	$149.88	$734.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $81.42 / $152.85 / $580.91	Professional		$81.42	$152.85	$580.91
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $1,081.34 / $1,081.34 / $1,081.34	Professional	50	$1,081.34	$1,081.34	$1,081.34
Midlands Facility/Professional Facility Modifier Low / Median / High Price $74.02 / $140.00 / $204.05	Facility		$74.02	$140.00	$204.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $108.61 / $151.63 / $215.85	Professional		$108.61	$151.63	$215.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $96.66 / $155.99	Professional		$55.55	$96.66	$155.99
United Facility/Professional Facility Modifier Low / Median / High Price $387.60 / $887.22 / $1,966.00	Facility		$387.60	$887.22	$1,966.00
United Facility/Professional Professional Modifier Low / Median / High Price $77.72 / $138.41 / $240.96	Professional		$77.72	$138.41	$240.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.70 / $129.10 / $188.80	Professional		$109.70	$129.10	$188.80