Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.30 / $1,663.83 / $5,549.00	Facility		$177.30	$1,663.83	$5,549.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.23 / $137.25 / $437.53	Professional		$53.23	$137.25	$437.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.98 / $177.11 / $466.93	Professional		$71.98	$177.11	$466.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $55.03 / $207.81 / $339.39	Professional		$55.03	$207.81	$339.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.32 / $250.16 / $1,564.36	Facility		$93.32	$250.16	$1,564.36
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $207.08 / $207.08 / $207.08	Facility	52	$207.08	$207.08	$207.08
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $51.77 / $51.77 / $51.77	Facility	53	$51.77	$51.77	$51.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $148.93 / $346.11 / $1,376.00	Professional		$148.93	$346.11	$1,376.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $130.34 / $250.99 / $466.93	Facility		$130.34	$250.99	$466.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $124.45 / $250.99 / $466.93	Professional		$124.45	$250.99	$466.93
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $944.57 / $944.57 / $944.57	Facility		$944.57	$944.57	$944.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.65 / $189.84 / $366.24	Professional		$56.65	$189.84	$366.24
United Facility/Professional Facility Modifier Low / Median / High Price $1,321.00 / $3,482.00 / $5,454.00	Facility		$1,321.00	$3,482.00	$5,454.00
United Facility/Professional Professional Modifier Low / Median / High Price $163.12 / $262.26 / $533.58	Professional		$163.12	$262.26	$533.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $109.70 / $134.30 / $420.50	Professional		$109.70	$134.30	$420.50