Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.64 / $1,958.61 / $5,463.36	Facility		$223.64	$1,958.61	$5,463.36
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $473.88 / $690.75 / $3,651.90	Facility	50	$473.88	$690.75	$3,651.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.66 / $182.27 / $492.46	Professional		$70.66	$182.27	$492.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $116.81 / $608.27 / $1,357.50	Professional	50	$116.81	$608.27	$1,357.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.78 / $293.57 / $477.20	Professional		$181.78	$293.57	$477.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.56 / $216.93 / $497.39	Professional		$79.56	$216.93	$497.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $132.33 / $316.43 / $1,151.00	Facility		$132.33	$316.43	$1,151.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,837.30 / $1,837.30 / $1,837.30	Facility	50	$1,837.30	$1,837.30	$1,837.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $176.64 / $329.67 / $1,587.70	Professional		$176.64	$329.67	$1,587.70
Midlands Facility/Professional Facility Modifier Low / Median / High Price $181.96 / $329.00 / $447.39	Facility		$181.96	$329.00	$447.39
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.96 / $314.18 / $447.39	Professional		$181.96	$314.18	$447.39
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $397.40 / $397.40 / $397.40	Facility		$397.40	$397.40	$397.40
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 $161.28 / $245.76 / $487.85	Professional		$161.28	$245.76	$487.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $160.40 / $249.40 / $371.50	Professional		$160.40	$249.40	$371.50