Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.50 / $379.96 / $6,066.00	Facility		$120.50	$379.96	$6,066.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.42 / $108.44 / $341.00	Professional		$38.42	$108.44	$341.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.94 / $117.84 / $325.58	Professional		$49.94	$117.84	$325.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.26 / $135.26 / $289.99	Professional		$40.26	$135.26	$289.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.43 / $129.13 / $325.58	Facility		$68.43	$129.13	$325.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.72 / $202.67 / $870.16	Professional		$93.72	$202.67	$870.16
Midlands Facility/Professional Facility Modifier Low / Median / High Price $92.11 / $187.39 / $323.06	Facility		$92.11	$187.39	$323.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $88.45 / $139.00 / $323.06	Professional		$88.45	$139.00	$323.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.82 / $101.66 / $216.64	Professional		$40.82	$101.66	$216.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,026.00 / $1,607.00 / $1,966.00	Facility		$1,026.00	$1,607.00	$1,966.00
United Facility/Professional Professional Modifier Low / Median / High Price $100.80 / $154.41 / $310.48	Professional		$100.80	$154.41	$310.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $80.20 / $98.10 / $259.00	Professional		$80.20	$98.10	$259.00