Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $201.16 / $2,218.00 / $6,298.62	Facility		$201.16	$2,218.00	$6,298.62
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $757.95 / $757.95 / $757.95	Facility	54	$757.95	$757.95	$757.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.55 / $428.81 / $698.07	Professional		$271.55	$428.81	$698.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $521.00 / $729.93 / $917.56	Professional		$521.00	$729.93	$917.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $294.18 / $479.71 / $1,330.30	Professional		$294.18	$479.71	$1,330.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $343.82 / $658.50 / $902.61	Facility		$343.82	$658.50	$902.61
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $1,151.73 / $1,151.73 / $1,151.73	Facility	52	$1,151.73	$1,151.73	$1,151.73
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $1,007.76 / $1,007.76 / $1,007.76	Facility	54	$1,007.76	$1,007.76	$1,007.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $331.30 / $668.84 / $2,296.32	Professional		$331.30	$668.84	$2,296.32
Midlands Facility/Professional Facility Modifier Low / Median / High Price $207.58 / $661.18 / $917.56	Facility		$207.58	$661.18	$917.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $517.00 / $715.71 / $917.56	Professional		$517.00	$715.71	$917.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $269.32 / $500.10 / $706.47	Professional		$269.32	$500.10	$706.47
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 $314.74 / $481.06 / $884.86	Professional		$314.74	$481.06	$884.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $534.83 / $677.00 / $796.50	Professional		$534.83	$677.00	$796.50