Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $457.09	Professional		$77.62	$91.20	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $239.88	Professional		$190.55	$190.55	$239.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $151.36 / $436.52	Professional		$83.18	$151.36	$436.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $1,548.82 / $5,248.07	Facility		$131.83	$1,548.82	$5,248.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $1,862.09	Professional		$100.00	$169.82	$1,862.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $194.98 / $295.12	Professional		$177.83	$194.98	$295.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $218.78 / $223.87	Professional		$154.88	$218.78	$223.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $173.78 / $213.80	Professional		$107.15	$173.78	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $4,677.35 / $6,309.57	Facility		$2,570.40	$4,677.35	$6,309.57
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $251.19	Professional		$87.10	$134.90	$251.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $181.97	Professional		$154.88	$154.88	$181.97