Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $667.45 / $5,074.68 / $7,349.01	Facility		$667.45	$5,074.68	$7,349.01
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,584.17 / $4,017.66 / $12,045.04	Facility	50	$3,584.17	$4,017.66	$12,045.04
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $2,631.28 / $2,631.28 / $2,631.28	Facility	52	$2,631.28	$2,631.28	$2,631.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.30 / $427.61 / $1,117.52	Professional		$158.30	$427.61	$1,117.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $139.72 / $1,028.00 / $1,624.82	Professional	50	$139.72	$1,028.00	$1,624.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $337.70 / $764.35 / $1,099.11	Professional		$337.70	$764.35	$1,099.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $143.25 / $516.04 / $907.87	Professional		$143.25	$516.04	$907.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $346.59 / $994.01 / $7,271.65	Facility		$346.59	$994.01	$7,271.65
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $775.66 / $775.66 / $775.66	Facility	52	$775.66	$775.66	$775.66
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $193.91 / $193.91 / $193.91	Facility	53	$193.91	$193.91	$193.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $408.34 / $1,058.81 / $4,715.39	Professional		$408.34	$1,058.81	$4,715.39
Midlands Facility/Professional Facility Modifier Low / Median / High Price $364.37 / $981.24 / $3,170.91	Facility		$364.37	$981.24	$3,170.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $337.70 / $764.35 / $1,192.11	Professional		$337.70	$764.35	$1,192.11
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,541.04 / $20,069.32 / $34,665.16	Facility		$3,541.04	$20,069.32	$34,665.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $1,043.90 / $1,150.70	Professional		$3.00	$1,043.90	$1,150.70
United Facility/Professional Facility Modifier Low / Median / High Price $4,217.00 / $5,732.00 / $8,342.00	Facility		$4,217.00	$5,732.00	$8,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $491.95 / $936.58 / $1,392.55	Professional		$491.95	$936.58	$1,392.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $297.80 / $350.30 / $846.40	Professional		$297.80	$350.30	$846.40