Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $3,419.00 / $6,446.00	Facility		$814.00	$3,419.00	$6,446.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.10 / $145.52 / $429.00	Professional		$92.10	$145.52	$429.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.42 / $253.21 / $358.39	Professional		$199.42	$253.21	$358.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.98 / $180.02 / $304.36	Professional		$83.98	$180.02	$304.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.46 / $255.38 / $1,151.00	Facility		$133.46	$255.38	$1,151.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $145.08 / $268.85 / $943.60	Professional		$145.08	$268.85	$943.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $109.94 / $209.80 / $323.48	Facility		$109.94	$209.80	$323.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $172.00 / $238.76 / $334.24	Professional		$172.00	$238.76	$334.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $198.30 / $331.80	Professional		$3.00	$198.30	$331.80
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 $130.85 / $234.39 / $370.39	Professional		$130.85	$234.39	$370.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $172.70 / $203.20 / $281.80	Professional		$172.70	$203.20	$281.80