Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $584.89 / $1,595.88 / $4,964.00	Facility		$584.89	$1,595.88	$4,964.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,523.52 / $1,523.52 / $1,523.52	Facility	50	$1,523.52	$1,523.52	$1,523.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.64 / $306.45 / $888.09	Professional		$101.64	$306.45	$888.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.96 / $668.84 / $1,059.33	Professional		$239.96	$668.84	$1,059.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.34 / $360.61 / $508.16	Professional		$100.34	$360.61	$508.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $248.39 / $737.32 / $2,033.70	Facility		$248.39	$737.32	$2,033.70
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $388.74 / $388.74 / $388.74	Facility	52	$388.74	$388.74	$388.74
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $97.18 / $97.18 / $97.18	Facility	53	$97.18	$97.18	$97.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $289.02 / $767.89 / $2,804.09	Professional		$289.02	$767.89	$2,804.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $264.73 / $561.08 / $829.79	Facility		$264.73	$561.08	$829.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $233.62 / $561.08 / $866.37	Professional		$233.62	$561.08	$866.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $871.60 / $1,479.60	Professional		$4.00	$871.60	$1,479.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,775.00 / $3,522.00 / $5,454.00	Facility		$1,775.00	$3,522.00	$5,454.00
United Facility/Professional Professional Modifier Low / Median / High Price $352.80 / $726.88 / $1,576.48	Professional		$352.80	$726.88	$1,576.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $197.80 / $232.70 / $666.30	Professional		$197.80	$232.70	$666.30