Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.27 / $2,301.00 / $6,298.62	Facility		$123.27	$2,301.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $68.95 / $241.93	Professional		$41.85	$68.95	$241.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.61 / $114.92 / $187.96	Professional		$79.61	$114.92	$187.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.83 / $88.45 / $155.78	Professional		$40.83	$88.45	$155.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.88 / $108.60 / $758.10	Facility		$64.88	$108.60	$758.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.29 / $119.09 / $437.98	Professional		$65.29	$119.09	$437.98
Midlands Facility/Professional Facility Modifier Low / Median / High Price $62.67 / $107.00 / $165.03	Facility		$62.67	$107.00	$165.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $84.61 / $116.39 / $169.39	Professional		$84.61	$116.39	$169.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.09 / $75.01 / $120.49	Professional		$40.09	$75.01	$120.49
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 $61.31 / $94.49 / $174.00	Professional		$61.31	$94.49	$174.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.59 / $93.60 / $148.69	Professional		$79.59	$93.60	$148.69