Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $662.00 / $3,419.00 / $6,446.00	Facility		$662.00	$3,419.00	$6,446.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.78 / $107.01 / $202.46	Professional		$38.78	$107.01	$202.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $145.31 / $341.83	Professional		$64.59	$145.31	$341.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $32.52 / $158.52 / $325.12	Professional		$32.52	$158.52	$325.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.20 / $187.72 / $512.74	Facility		$84.20	$187.72	$512.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.53 / $253.28 / $878.88	Professional		$110.53	$253.28	$878.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $86.69 / $173.38 / $322.54	Facility		$86.69	$173.38	$322.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.69 / $207.56 / $322.54	Professional		$75.69	$207.56	$322.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $109.43 / $208.31	Professional		$33.61	$109.43	$208.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,026.00 / $1,623.00 / $2,126.00	Facility		$1,026.00	$1,623.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $124.15 / $181.90 / $370.10	Professional		$124.15	$181.90	$370.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.40 / $84.90 / $273.20	Professional		$69.40	$84.90	$273.20