Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $728.09 / $2,563.00 / $6,446.00	Facility		$728.09	$2,563.00	$6,446.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $117.30 / $356.00	Professional		$60.27	$117.30	$356.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.33 / $163.89 / $271.70	Professional		$129.33	$163.89	$271.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.79 / $135.57 / $237.29	Professional		$54.79	$135.57	$237.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.07 / $180.64 / $2,651.52	Facility		$104.07	$180.64	$2,651.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.64 / $195.10 / $716.40	Professional		$109.64	$195.10	$716.40
Midlands Facility/Professional Facility Modifier Low / Median / High Price $85.39 / $144.94 / $237.51	Facility		$85.39	$144.94	$237.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.84 / $165.25 / $245.01	Professional		$123.84	$165.25	$245.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $150.50 / $254.50	Professional		$3.00	$150.50	$254.50
United Facility/Professional Facility Modifier Low / Median / High Price $1,775.00 / $3,522.00 / $5,454.00	Facility		$1,775.00	$3,522.00	$5,454.00
United Facility/Professional Professional Modifier Low / Median / High Price $98.51 / $176.46 / $278.85	Professional		$98.51	$176.46	$278.85
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $111.60 / $131.30 / $212.90	Professional		$111.60	$131.30	$212.90