Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.79 / $2,352.00 / $6,446.00	Facility		$173.79	$2,352.00	$6,446.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $546.87 / $669.72 / $1,997.56	Facility	50	$546.87	$669.72	$1,997.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.44 / $75.04 / $201.00	Professional		$37.44	$75.04	$201.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $49.83 / $137.00 / $297.00	Professional	50	$49.83	$137.00	$297.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.25 / $99.34 / $153.87	Professional		$67.25	$99.34	$153.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.51 / $72.59 / $150.00	Professional		$35.51	$72.59	$150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.15 / $98.96 / $734.94	Facility		$55.15	$98.96	$734.94
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $227.58 / $227.58 / $227.58	Facility	50	$227.58	$227.58	$227.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $100.34 / $400.96	Professional		$54.95	$100.34	$400.96
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $128.97 / $128.97 / $180.72	Professional	50	$128.97	$128.97	$180.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $47.01 / $94.25 / $133.01	Facility		$47.01	$94.25	$133.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.51 / $100.00 / $138.43	Professional		$72.51	$100.00	$138.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.65 / $60.35 / $99.67	Professional		$34.65	$60.35	$99.67
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 $50.17 / $76.45 / $153.06	Professional		$50.17	$76.45	$153.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $68.70 / $82.16 / $122.30	Professional		$68.70	$82.16	$122.30