Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $2,570.40 / $6,760.83	Facility		$204.17	$2,570.40	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $309.03	Professional		$107.15	$151.36	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $295.12 / $354.81	Professional		$288.40	$295.12	$354.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $229.09 / $549.54	Professional		$125.89	$229.09	$549.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $1,318.26 / $4,786.30	Facility		$223.87	$1,318.26	$4,786.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $275.42 / $1,949.84	Professional		$147.91	$275.42	$1,949.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $302.00 / $457.09	Professional		$275.42	$302.00	$457.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $331.13 / $331.13	Professional		$245.47	$331.13	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.02 / $269.15 / $407.38	Professional		$3.02	$269.15	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,890.45 / $5,370.32	Facility		$1,819.70	$3,890.45	$5,370.32
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $208.93 / $398.11	Professional		$134.90	$208.93	$398.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $275.42	Professional		$234.42	$234.42	$275.42