Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $819.18 / $2,906.00 / $6,298.62	Facility		$819.18	$2,906.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.87 / $607.60 / $1,322.35	Professional		$256.87	$607.60	$1,322.35
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 $343.28 / $709.79 / $1,873.55	Professional		$343.28	$709.79	$1,873.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $242.32 / $865.79 / $1,478.97	Professional		$242.32	$865.79	$1,478.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $448.74 / $1,056.98 / $2,433.04	Facility		$448.74	$1,056.98	$2,433.04
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $926.46 / $926.46 / $926.46	Facility	52	$926.46	$926.46	$926.46
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $231.61 / $231.61 / $231.61	Facility	53	$231.61	$231.61	$231.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $695.17 / $1,410.48 / $4,908.96	Professional		$695.17	$1,410.48	$4,908.96
Midlands Facility/Professional Facility Modifier Low / Median / High Price $609.85 / $1,085.56 / $1,850.46	Facility		$609.85	$1,085.56	$1,850.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $556.76 / $1,085.56 / $1,873.55	Professional		$556.76	$1,085.56	$1,873.55
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $968.82 / $968.82 / $968.82	Facility		$968.82	$968.82	$968.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $247.44 / $659.99 / $1,322.20	Professional		$247.44	$659.99	$1,322.20
United Facility/Professional Facility Modifier Low / Median / High Price $1,770.00 / $4,663.00 / $7,305.00	Facility		$1,770.00	$4,663.00	$7,305.00
United Facility/Professional Professional Modifier Low / Median / High Price $694.14 / $1,059.31 / $2,155.23	Professional		$694.14	$1,059.31	$2,155.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $490.90 / $600.70 / $1,463.20	Professional		$490.90	$600.70	$1,463.20