Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $2,454.71 / $6,456.54	Facility		$446.68	$2,454.71	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $229.09 / $645.65	Professional		$85.11	$229.09	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility		$1,202.26	$1,202.26	$1,202.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $245.47 / $630.96	Professional		$104.71	$245.47	$630.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $346.74 / $831.76	Professional		$85.11	$346.74	$831.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $380.19 / $2,398.83	Facility		$123.03	$380.19	$2,398.83
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $338.84 / $338.84 / $338.84	Facility	52	$338.84	$338.84	$338.84
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $85.11 / $85.11 / $85.11	Facility	53	$85.11	$85.11	$85.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $467.74 / $1,949.84	Professional		$229.09	$467.74	$1,949.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $426.58 / $645.65	Professional		$199.53	$426.58	$645.65
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility		$1,202.26	$1,202.26	$1,202.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $416.87 / $707.95	Professional		$204.17	$416.87	$707.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $269.15 / $588.84	Professional		$85.11	$269.15	$588.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $3,162.28 / $6,309.57	Facility		$1,412.54	$3,162.28	$6,309.57
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $239.88 / $562.34	Professional		$100.00	$239.88	$562.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $204.17 / $588.84	Professional		$169.82	$204.17	$588.84