Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $376.74 / $2,352.00 / $6,298.62	Facility		$376.74	$2,352.00	$6,298.62
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $407.21 / $407.21 / $407.21	Facility	54	$407.21	$407.21	$407.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $455.07 / $627.25 / $903.78	Professional		$455.07	$627.25	$903.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $905.67 / $1,222.35 / $1,557.23	Professional		$905.67	$1,222.35	$1,557.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $474.34 / $792.44 / $1,629.91	Professional		$474.34	$792.44	$1,629.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $751.84 / $1,222.35 / $3,396.00	Facility		$751.84	$1,222.35	$3,396.00
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $1,610.71 / $1,610.71 / $1,610.71	Facility	54	$1,610.71	$1,610.71	$1,610.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $577.20 / $1,106.26 / $3,960.27	Professional		$577.20	$1,106.26	$3,960.27
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,005.44 / $1,222.35 / $1,597.29	Facility		$1,005.44	$1,222.35	$1,597.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $897.25 / $1,211.59 / $1,468.81	Professional		$897.25	$1,211.59	$1,468.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $503.97 / $917.97 / $1,727.45	Professional		$503.97	$917.97	$1,727.45
United Facility/Professional Facility Modifier Low / Median / High Price $3,044.00 / $4,663.00 / $7,305.00	Facility		$3,044.00	$4,663.00	$7,305.00
United Facility/Professional Professional Modifier Low / Median / High Price $529.39 / $806.69 / $1,502.46	Professional		$529.39	$806.69	$1,502.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $844.12 / $1,068.50 / $1,257.09	Professional		$844.12	$1,068.50	$1,257.09