Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.75 / $2,546.00 / $6,298.62	Facility		$127.75	$2,546.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $67.23 / $215.28	Professional		$39.93	$67.23	$215.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.93 / $115.89 / $172.38	Professional		$82.93	$115.89	$172.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $39.43 / $80.70 / $150.00	Professional		$39.43	$80.70	$150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.23 / $113.64 / $787.90	Facility		$67.23	$113.64	$787.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.23 / $129.12 / $453.23	Professional		$67.23	$129.12	$453.23
Midlands Facility/Professional Facility Modifier Low / Median / High Price $52.95 / $109.00 / $153.72	Facility		$52.95	$109.00	$153.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $86.43 / $118.60 / $165.76	Professional		$86.43	$118.60	$165.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $67.78 / $110.10	Professional		$42.35	$67.78	$110.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,640.00 / $2,126.00	Facility		$1,204.00	$1,640.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $96.83 / $180.35	Professional		$62.40	$96.83	$180.35
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.59 / $93.60 / $136.69	Professional		$79.59	$93.60	$136.69