Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $692.17 / $2,906.00 / $5,463.36	Facility		$692.17	$2,906.00	$5,463.36
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,370.80 / $1,370.80 / $1,370.80	Facility	52	$1,370.80	$1,370.80	$1,370.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.24 / $434.47 / $1,245.50	Professional		$192.24	$434.47	$1,245.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $96.12 / $202.17 / $528.16	Professional	52	$96.12	$202.17	$528.16
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $38.45 / $75.36 / $211.26	Professional	53	$38.45	$75.36	$211.26
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 $288.33 / $553.16 / $1,219.00	Professional		$288.33	$553.16	$1,219.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $188.06 / $568.75 / $1,206.22	Professional		$188.06	$568.75	$1,206.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $366.66 / $805.23 / $1,708.54	Facility		$366.66	$805.23	$1,708.54
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $721.81 / $721.81 / $721.81	Facility	52	$721.81	$721.81	$721.81
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $180.45 / $180.45 / $180.45	Facility	53	$180.45	$180.45	$180.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $462.14 / $898.70 / $3,212.16	Professional		$462.14	$898.70	$3,212.16
Midlands Facility/Professional Facility Modifier Low / Median / High Price $471.24 / $943.53 / $1,193.67	Facility		$471.24	$943.53	$1,193.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $433.78 / $805.23 / $1,204.88	Professional		$433.78	$805.23	$1,204.88
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $584.97 / $868.80 / $2,476.08	Facility		$584.97	$868.80	$2,476.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $193.08 / $441.76 / $1,300.43	Professional		$193.08	$441.76	$1,300.43
United Facility/Professional Facility Modifier Low / Median / High Price $637.00 / $3,044.00 / $5,934.99	Facility		$637.00	$3,044.00	$5,934.99
United Facility/Professional Professional Modifier Low / Median / High Price $442.05 / $670.24 / $1,308.17	Professional		$442.05	$670.24	$1,308.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $382.50 / $468.00 / $967.90	Professional		$382.50	$468.00	$967.90