Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $227.86 / $2,256.00 / $5,549.00	Facility		$227.86	$2,256.00	$5,549.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.84 / $188.45 / $506.61	Professional		$71.84	$188.45	$506.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $646.00 / $646.00 / $646.00	Facility		$646.00	$646.00	$646.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.06 / $251.68 / $734.14	Professional		$95.06	$251.68	$734.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.12 / $288.61 / $451.09	Professional		$70.12	$288.61	$451.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $119.93 / $303.07 / $1,564.36	Facility		$119.93	$303.07	$1,564.36
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $262.79 / $262.79 / $262.79	Facility	52	$262.79	$262.79	$262.79
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $65.70 / $65.70 / $65.70	Facility	53	$65.70	$65.70	$65.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.96 / $515.29 / $2,112.88	Professional		$190.96	$515.29	$2,112.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $167.02 / $612.07 / $921.87	Facility		$167.02	$612.07	$921.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $157.93 / $312.49 / $734.14	Professional		$157.93	$312.49	$734.14
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $971.14 / $971.14 / $971.14	Facility		$971.14	$971.14	$971.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $286.20 / $982.15	Professional		$71.34	$286.20	$982.15
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 $226.24 / $412.58 / $839.41	Professional		$226.24	$412.58	$839.41
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $139.30 / $170.40 / $635.00	Professional		$139.30	$170.40	$635.00