Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $3,090.30 / $6,760.83	Facility		$177.83	$3,090.30	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $1,318.26 / $3,090.30	Professional		$120.23	$1,318.26	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $2,691.53 / $3,715.35	Professional		$257.04	$2,691.53	$3,715.35
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $1,584.89 / $2,630.27	Professional		$125.89	$1,584.89	$2,630.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $3,090.30 / $5,623.41	Facility		$275.42	$3,090.30	$5,623.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $2,691.53 / $4,897.79	Professional		$309.03	$2,691.53	$4,897.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $2,691.53 / $3,630.78	Professional		$281.84	$2,691.53	$3,630.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $3,548.13	Professional		$309.03	$309.03	$3,548.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $281.84 / $2,570.40	Professional		$117.49	$281.84	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $5,011.87 / $6,760.83	Facility		$2,691.53	$5,011.87	$6,760.83
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $1,348.96 / $4,265.80	Professional		$138.04	$1,348.96	$4,265.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $275.42 / $2,884.03	Professional		$234.42	$275.42	$2,884.03