Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $2,570.40 / $6,760.83	Facility		$223.87	$2,570.40	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $524.81	Professional		$128.82	$165.96	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $316.23 / $398.11	Professional		$257.04	$316.23	$398.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $616.60	Professional		$134.90	$199.53	$616.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $323.59 / $1,905.46	Facility		$154.88	$323.59	$1,905.46
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $66.07 / $66.07 / $66.07	Facility	AS	$66.07	$66.07	$66.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $288.40 / $1,905.46	Professional		$147.91	$288.40	$1,905.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $331.13 / $389.05	Professional		$275.42	$331.13	$389.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $288.40 / $389.05	Professional		$281.84	$288.40	$389.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $234.42 / $309.03	Professional		$131.83	$234.42	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,621.81 / $3,548.13	Facility		$1,148.15	$1,621.81	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $208.93 / $407.38	Professional		$144.54	$208.93	$407.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $275.42 / $323.59	Professional		$218.78	$275.42	$323.59