Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.62 / $1,300.00 / $6,298.62	Facility		$152.62	$1,300.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.21 / $116.69 / $270.00	Professional		$48.21	$116.69	$270.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.20 / $134.38 / $340.00	Professional		$61.20	$134.38	$340.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $168.06 / $254.56	Professional		$46.93	$168.06	$254.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.33 / $157.76 / $1,321.12	Facility		$80.33	$157.76	$1,321.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.21 / $250.16 / $946.80	Professional		$112.21	$250.16	$946.80
Midlands Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $166.99 / $330.04	Facility		$111.95	$166.99	$330.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $106.27 / $185.26 / $330.04	Professional		$106.27	$185.26	$330.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $48.32 / $135.97 / $262.80	Professional		$48.32	$135.97	$262.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,197.08 / $2,341.42 / $5,454.00	Facility		$1,197.08	$2,341.42	$5,454.00
United Facility/Professional Professional Modifier Low / Median / High Price $120.90 / $207.32 / $377.58	Professional		$120.90	$207.32	$377.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $93.70 / $114.60 / $292.89	Professional		$93.70	$114.60	$292.89