Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $2,290.87 / $6,456.54	Facility		$281.84	$2,290.87	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $446.68 / $1,318.26	Professional		$281.84	$446.68	$1,318.26
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $239.88 / $407.38 / $1,122.02	Professional	54	$239.88	$407.38	$1,122.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $831.76 / $1,047.13	Professional		$416.87	$831.76	$1,047.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $436.52 / $1,122.02	Professional		$257.04	$436.52	$1,122.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $645.65 / $1,348.96	Facility		$346.74	$645.65	$1,348.96
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility	54	$1,096.48	$1,096.48	$1,096.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $676.08 / $2,511.89	Professional		$323.59	$676.08	$2,511.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $812.83 / $933.25	Professional		$616.60	$812.83	$933.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $630.96 / $933.25	Professional		$575.44	$630.96	$933.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $616.60 / $812.83	Professional		$338.84	$616.60	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,202.26 / $2,344.23	Facility		$537.03	$1,202.26	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $436.52 / $870.96	Professional		$288.40	$436.52	$870.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $691.83 / $812.83	Professional		$549.54	$691.83	$812.83