Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $388.79 / $3,034.03 / $6,298.62	Facility		$388.79	$3,034.03	$6,298.62
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $196.56 / $196.56 / $196.56	Facility	52	$196.56	$196.56	$196.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.51 / $261.22 / $803.67	Professional		$74.51	$261.22	$803.67
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $47.24 / $138.50 / $401.24	Professional	52	$47.24	$138.50	$401.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.35 / $205.04 / $554.13	Professional		$143.35	$205.04	$554.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $59.31 / $260.12 / $472.51	Professional		$59.31	$260.12	$472.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $148.63 / $333.12 / $1,151.00	Facility		$148.63	$333.12	$1,151.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $233.74 / $233.74 / $233.74	Facility	52	$233.74	$233.74	$233.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $169.39 / $437.54 / $1,386.56	Professional		$169.39	$437.54	$1,386.56
Midlands Facility/Professional Facility Modifier Low / Median / High Price $148.63 / $200.36 / $508.68	Facility		$148.63	$200.36	$508.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $140.47 / $313.73 / $527.29	Professional		$140.47	$313.73	$527.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $408.20 / $513.00	Professional		$5.00	$408.20	$513.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,607.00 / $2,126.00	Facility		$1,204.00	$1,607.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $205.22 / $372.45 / $588.55	Professional		$205.22	$372.45	$588.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $118.90 / $139.90 / $412.50	Professional		$118.90	$139.90	$412.50