Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.36 / $2,546.00 / $6,446.00	Facility		$169.36	$2,546.00	$6,446.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.04 / $95.58 / $172.00	Professional		$51.04	$95.58	$172.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.81 / $151.91 / $274.63	Professional		$64.81	$151.91	$274.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $51.97 / $126.66 / $265.45	Professional		$51.97	$126.66	$265.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.14 / $154.62 / $1,097.09	Facility		$89.14	$154.62	$1,097.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.72 / $218.61 / $728.98	Professional		$115.72	$218.61	$728.98
Midlands Facility/Professional Facility Modifier Low / Median / High Price $108.60 / $160.75 / $265.13	Facility		$108.60	$160.75	$265.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $115.72 / $178.58 / $274.99	Professional		$115.72	$178.58	$274.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.19 / $101.07 / $207.00	Professional		$50.19	$101.07	$207.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,321.00 / $3,482.00 / $5,454.00	Facility		$1,321.00	$3,482.00	$5,454.00
United Facility/Professional Professional Modifier Low / Median / High Price $102.49 / $166.18 / $301.19	Professional		$102.49	$166.18	$301.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $102.00 / $124.80 / $212.90	Professional		$102.00	$124.80	$212.90