Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $572.00 / $2,977.00 / $5,648.76	Facility		$572.00	$2,977.00	$5,648.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.03 / $357.17 / $1,034.69	Professional		$171.03	$357.17	$1,034.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $953.00 / $953.00 / $953.00	Facility		$953.00	$953.00	$953.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.29 / $465.98 / $940.88	Professional		$222.29	$465.98	$940.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.18 / $433.06 / $843.65	Professional		$165.18	$433.06	$843.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $293.70 / $614.64 / $1,976.72	Facility		$293.70	$614.64	$1,976.72
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $633.38 / $633.38 / $633.38	Facility	52	$633.38	$633.38	$633.38
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $158.34 / $158.34 / $158.34	Facility	53	$158.34	$158.34	$158.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $297.00 / $700.20 / $2,839.20	Professional		$297.00	$700.20	$2,839.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $337.46 / $765.44 / $1,006.78	Facility		$337.46	$765.44	$1,006.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $332.52 / $527.54 / $1,033.05	Professional		$332.52	$527.54	$1,033.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $169.21 / $386.18 / $999.22	Professional		$169.21	$386.18	$999.22
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 $286.36 / $572.21 / $1,138.70	Professional		$286.36	$572.21	$1,138.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $335.60 / $410.70 / $855.40	Professional		$335.60	$410.70	$855.40