Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.54 / $202.35 / $4,277.00	Facility		$56.54	$202.35	$4,277.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.78 / $89.98 / $170.96	Professional		$34.78	$89.98	$170.96
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.36 / $28.55 / $44.99	Professional	52	$18.36	$28.55	$44.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.32 / $134.63 / $180.17	Professional		$55.32	$134.63	$180.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $23.04 / $93.86 / $231.85	Professional		$23.04	$93.86	$231.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $62.06 / $150.81 / $1,204.00	Facility		$62.06	$150.81	$1,204.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $89.63 / $89.63 / $89.63	Facility	52	$89.63	$89.63	$89.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.52 / $143.28 / $552.69	Professional		$65.52	$143.28	$552.69
Midlands Facility/Professional Facility Modifier Low / Median / High Price $59.55 / $134.63 / $187.97	Facility		$59.55	$134.63	$187.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $129.97 / $178.79	Professional		$53.87	$129.97	$178.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $132.10 / $165.60	Professional		$3.00	$132.10	$165.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,607.00 / $2,126.00	Facility		$1,204.00	$1,607.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $69.11 / $133.66 / $187.47	Professional		$69.11	$133.66	$187.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $47.50 / $55.90 / $139.69	Professional		$47.50	$55.90	$139.69