Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $221.25 / $2,563.00 / $6,066.00	Facility		$221.25	$2,563.00	$6,066.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.27 / $148.72 / $331.02	Professional		$68.27	$148.72	$331.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.04 / $247.35 / $554.13	Professional		$110.04	$247.35	$554.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.22 / $253.54 / $473.73	Professional		$67.22	$253.54	$473.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $138.75 / $324.13 / $749.52	Facility		$138.75	$324.13	$749.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $189.47 / $403.37 / $2,530.30	Professional		$189.47	$403.37	$2,530.30
Midlands Facility/Professional Facility Modifier Low / Median / High Price $138.75 / $285.07 / $496.24	Facility		$138.75	$285.07	$496.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.75 / $314.00 / $524.84	Professional		$138.75	$314.00	$524.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $252.00 / $450.50	Professional		$3.00	$252.00	$450.50
United Facility/Professional Facility Modifier Low / Median / High Price $1,026.00 / $1,623.00 / $2,126.00	Facility		$1,026.00	$1,623.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $192.08 / $326.54 / $568.44	Professional		$192.08	$326.54	$568.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.60 / $169.60 / $429.60	Professional		$138.60	$169.60	$429.60