Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $2,546.00 / $5,812.62	Facility		$650.00	$2,546.00	$5,812.62
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,609.25 / $1,609.25 / $1,609.25	Facility	52	$1,609.25	$1,609.25	$1,609.25
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $2,372.94 / $2,372.94 / $2,372.94	Facility	53	$2,372.94	$2,372.94	$2,372.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $294.61 / $946.30	Professional		$117.60	$294.61	$946.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $733.00 / $733.00 / $733.00	Facility		$733.00	$733.00	$733.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.37 / $360.40 / $778.24	Professional		$162.37	$360.40	$778.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $118.47 / $369.86 / $768.73	Professional		$118.47	$369.86	$768.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $207.94 / $515.00 / $1,976.72	Facility		$207.94	$515.00	$1,976.72
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $442.02 / $442.02 / $442.02	Facility	52	$442.02	$442.02	$442.02
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $110.50 / $110.50 / $110.50	Facility	53	$110.50	$110.50	$110.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $300.39 / $608.58 / $2,132.08	Professional		$300.39	$608.58	$2,132.08
Midlands Facility/Professional Facility Modifier Low / Median / High Price $287.33 / $621.54 / $916.95	Facility		$287.33	$621.54	$916.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $265.64 / $515.00 / $778.24	Professional		$265.64	$515.00	$778.24
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $947.15 / $4,731.89 / $13,485.95	Facility		$947.15	$4,731.89	$13,485.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $118.15 / $296.87 / $986.57	Professional		$118.15	$296.87	$986.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,770.00 / $4,663.00 / $7,305.00	Facility		$1,770.00	$4,663.00	$7,305.00
United Facility/Professional Professional Modifier Low / Median / High Price $290.06 / $491.71 / $858.39	Professional		$290.06	$491.71	$858.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $234.20 / $286.60 / $644.79	Professional		$234.20	$286.60	$644.79