Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $5,011.87 / $7,943.28	Facility		$58.88	$5,011.87	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $72.44 / $194.98	Professional		$38.02	$72.44	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $173.78 / $218.78	Professional		$91.20	$173.78	$218.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $125.89 / $213.80	Professional		$50.12	$125.89	$213.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $181.97 / $1,621.81	Facility		$91.20	$181.97	$1,621.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $131.83 / $645.65	Professional		$83.18	$131.83	$645.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $158.49 / $199.53	Professional		$91.20	$158.49	$199.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $107.15 / $199.53	Professional		$75.86	$107.15	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.02 / $151.36 / $194.98	Professional		$3.02	$151.36	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $1,202.26 / $2,344.23	Facility		$288.40	$1,202.26	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $95.50 / $186.21	Professional		$46.77	$95.50	$186.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $169.82	Professional		$77.62	$91.20	$169.82