Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $1,122.02 / $3,801.89	Facility		$218.78	$1,122.02	$3,801.89
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility	50	$1,513.56	$1,513.56	$1,513.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $316.23 / $2,137.96	Professional		$102.33	$316.23	$2,137.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $354.81 / $912.01	Professional		$245.47	$354.81	$912.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $363.08 / $954.99	Professional		$107.15	$363.08	$954.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $776.25 / $3,235.94	Facility		$251.19	$776.25	$3,235.94
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	52	$389.05	$389.05	$389.05
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $97.72 / $97.72 / $97.72	Facility	53	$97.72	$97.72	$97.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $691.83 / $1,862.09	Professional		$288.40	$691.83	$1,862.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $562.34 / $851.14	Professional		$234.42	$562.34	$851.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $1,258.93	Professional		$213.80	$295.12	$1,258.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.98 / $870.96 / $1,621.81	Professional		$3.98	$870.96	$1,621.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $2,041.74 / $4,897.79	Facility		$1,148.15	$2,041.74	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $338.84 / $954.99	Professional		$131.83	$338.84	$954.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $234.42 / $660.69	Professional		$199.53	$234.42	$660.69