Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.35 / $2,563.00 / $6,298.62	Facility		$225.35	$2,563.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.76 / $485.05 / $997.29	Professional		$66.76	$485.05	$997.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.87 / $362.80 / $1,608.13	Professional		$95.87	$362.80	$1,608.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.02 / $648.23 / $997.31	Professional		$66.02	$648.23	$997.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $118.61 / $840.40 / $2,840.84	Facility		$118.61	$840.40	$2,840.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.35 / $1,213.97 / $4,244.64	Professional		$187.35	$1,213.97	$4,244.64
Midlands Facility/Professional Facility Modifier Low / Median / High Price $169.78 / $1,213.97 / $1,629.89	Facility		$169.78	$1,213.97	$1,629.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $150.66 / $956.30 / $1,608.13	Professional		$150.66	$956.30	$1,608.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $515.13 / $1,715.33	Professional		$65.56	$515.13	$1,715.33
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 $613.95 / $893.79 / $1,818.48	Professional		$613.95	$893.79	$1,818.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $132.80 / $162.50 / $1,259.30	Professional		$132.80	$162.50	$1,259.30