Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.16 / $2,546.00 / $6,446.00	Facility		$251.16	$2,546.00	$6,446.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,195.55 / $2,466.46 / $4,147.93	Facility	50	$2,195.55	$2,466.46	$4,147.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.69 / $105.98 / $350.03	Professional		$57.69	$105.98	$350.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $139.41 / $307.72 / $673.50	Professional	50	$139.41	$307.72	$673.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.35 / $173.33 / $283.39	Professional		$124.35	$173.33	$283.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.84 / $131.57 / $293.23	Professional		$63.84	$131.57	$293.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $94.42 / $162.60 / $758.10	Facility		$94.42	$162.60	$758.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.47 / $185.82 / $437.52	Professional		$102.47	$185.82	$437.52
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $330.45 / $673.49 / $1,342.32	Professional	50	$330.45	$673.49	$1,342.32
Midlands Facility/Professional Facility Modifier Low / Median / High Price $94.00 / $145.35 / $251.27	Facility		$94.00	$145.35	$251.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.81 / $181.77 / $263.70	Professional		$128.81	$181.77	$263.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.46 / $109.19 / $184.19	Professional		$56.46	$109.19	$184.19
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 $93.61 / $142.63 / $283.22	Professional		$93.61	$142.63	$283.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $113.60 / $151.05 / $225.00	Professional		$113.60	$151.05	$225.00