Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $891.25 / $5,011.87	Facility		$93.33	$891.25	$5,011.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $158.49 / $562.34	Professional		$53.70	$158.49	$562.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $162.18 / $446.68	Professional		$66.07	$162.18	$446.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $186.21 / $416.87	Professional		$54.95	$186.21	$416.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $223.87 / $2,238.72	Facility		$79.43	$223.87	$2,238.72
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	52	$208.93	$208.93	$208.93
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $51.29 / $51.29 / $51.29	Facility	53	$51.29	$51.29	$51.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $309.03 / $1,380.38	Professional		$147.91	$309.03	$1,380.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $269.15 / $457.09	Professional		$131.83	$269.15	$457.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $281.84 / $512.86	Professional		$125.89	$281.84	$512.86
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $194.98 / $436.52	Professional		$56.23	$194.98	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,818.38 / $4,897.79	Facility		$1,318.26	$2,818.38	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $158.49 / $380.19	Professional		$64.57	$158.49	$380.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $416.87	Professional		$109.65	$134.90	$416.87