Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.13 / $1,586.11 / $5,549.00	Facility		$111.13	$1,586.11	$5,549.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $149.00 / $149.00 / $624.59	Facility	50	$149.00	$149.00	$624.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.57 / $74.40 / $173.79	Professional		$37.57	$74.40	$173.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $104.36 / $164.43 / $260.69	Professional	50	$104.36	$164.43	$260.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.44 / $109.81 / $156.79	Professional		$78.44	$109.81	$156.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $73.87 / $156.81	Professional		$36.54	$73.87	$156.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.18 / $102.92 / $758.10	Facility		$56.18	$102.92	$758.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.29 / $108.00 / $411.20	Professional		$59.29	$108.00	$411.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $48.08 / $97.83 / $136.41	Facility		$48.08	$97.83	$136.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $76.53 / $102.77 / $143.88	Professional		$76.53	$102.77	$143.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.60 / $61.55 / $101.42	Professional		$35.60	$61.55	$101.42
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 $51.08 / $79.18 / $156.68	Professional		$51.08	$79.18	$156.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $70.59 / $83.66 / $124.60	Professional		$70.59	$83.66	$124.60