Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $2,754.23 / $6,025.60	Facility		$436.52	$2,754.23	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $281.84 / $1,412.54	Professional		$72.44	$281.84	$1,412.54
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 $169.82 / $389.05 / $1,047.13	Professional		$169.82	$389.05	$1,047.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $478.63 / $1,096.48	Professional		$134.90	$478.63	$1,096.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $630.96 / $2,398.83	Facility		$208.93	$630.96	$2,398.83
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $501.19 / $501.19 / $501.19	Facility	52	$501.19	$501.19	$501.19
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $123.03 / $123.03 / $123.03	Facility	53	$123.03	$123.03	$123.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $676.08 / $2,754.23	Professional		$346.74	$676.08	$2,754.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $630.96 / $1,000.00	Professional		$323.59	$630.96	$1,000.00
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 $331.13 / $676.08 / $1,047.13	Professional		$331.13	$676.08	$1,047.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $389.05 / $851.14	Professional		$128.82	$389.05	$851.14
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 $162.18 / $380.19 / $851.14	Professional		$162.18	$380.19	$851.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $323.59 / $831.76	Professional		$263.03	$323.59	$831.76