Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $258.39 / $2,293.00 / $5,483.90	Facility		$258.39	$2,293.00	$5,483.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.87 / $136.53 / $593.00	Professional		$68.87	$136.53	$593.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.87 / $255.00 / $499.60	Professional		$162.87	$255.00	$499.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $208.91 / $325.36	Professional		$78.84	$208.91	$325.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $164.30 / $347.22 / $4,663.00	Facility		$164.30	$347.22	$4,663.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.18 / $289.00 / $1,293.59	Professional		$151.18	$289.00	$1,293.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $164.30 / $347.22 / $1,331.66	Facility		$164.30	$347.22	$1,331.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.87 / $234.98 / $428.90	Professional		$162.87	$234.98	$428.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $82.18 / $165.98 / $1,421.20	Professional		$82.18	$165.98	$1,421.20
United Facility/Professional Facility Modifier Low / Median / High Price $3,044.00 / $5,023.00 / $7,305.00	Facility		$3,044.00	$5,023.00	$7,305.00
United Facility/Professional Professional Modifier Low / Median / High Price $136.61 / $251.92 / $384.48	Professional		$136.61	$251.92	$384.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $160.80 / $189.10 / $382.00	Professional		$160.80	$189.10	$382.00