Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $485.01 / $2,802.83 / $5,050.93	Facility		$485.01	$2,802.83	$5,050.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.13 / $351.94 / $1,877.76	Professional		$147.13	$351.94	$1,877.76
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 $194.23 / $425.00 / $2,608.64	Professional		$194.23	$425.00	$2,608.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $147.82 / $436.64 / $1,659.12	Professional		$147.82	$436.64	$1,659.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $255.27 / $907.37 / $3,254.94	Facility		$255.27	$907.37	$3,254.94
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $551.04 / $551.04 / $551.04	Facility	52	$551.04	$551.04	$551.04
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $137.76 / $137.76 / $137.76	Facility	53	$137.76	$137.76	$137.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $258.00 / $1,790.14 / $7,882.64	Professional		$258.00	$1,790.14	$7,882.64
Midlands Facility/Professional Facility Modifier Low / Median / High Price $292.50 / $1,512.26 / $2,608.64	Facility		$292.50	$1,512.26	$2,608.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $283.00 / $1,176.95 / $2,806.71	Professional		$283.00	$1,176.95	$2,806.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $146.97 / $916.64 / $1,931.82	Professional		$146.97	$916.64	$1,931.82
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 $239.48 / $1,529.90 / $3,059.79	Professional		$239.48	$1,529.90	$3,059.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $292.00 / $357.30 / $2,313.30	Professional		$292.00	$357.30	$2,313.30