Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $132.01 / $2,546.00 / $6,446.00	Facility		$132.01	$2,546.00	$6,446.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.75 / $63.24 / $248.81	Professional		$40.75	$63.24	$248.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.61 / $110.49 / $123.21	Professional		$96.61	$110.49	$123.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.67 / $71.91 / $142.51	Professional		$40.67	$71.91	$142.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.89 / $115.78 / $1,775.00	Facility		$93.89	$115.78	$1,775.00
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	53	$50.00	$50.00	$50.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.60 / $109.65 / $200.79	Professional		$55.60	$109.65	$200.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $80.47 / $109.65 / $134.52	Facility		$80.47	$109.65	$134.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $80.47 / $105.78 / $137.75	Professional		$80.47	$105.78	$137.75
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,136.25 / $20,125.52 / $34,762.22	Facility		$3,136.25	$20,125.52	$34,762.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.79 / $74.33 / $80.83	Professional		$41.79	$74.33	$80.83
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 $50.24 / $90.00 / $144.61	Professional		$50.24	$90.00	$144.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $68.02 / $86.10 / $101.30	Professional		$68.02	$86.10	$101.30