Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $3,259.25 / $7,119.04	Facility		$1,300.00	$3,259.25	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.70 / $195.91 / $516.38	Professional		$121.70	$195.91	$516.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.63 / $328.95 / $455.77	Professional		$237.63	$328.95	$455.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $101.08 / $240.36 / $407.51	Professional		$101.08	$240.36	$407.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $164.09 / $312.19 / $1,151.00	Facility		$164.09	$312.19	$1,151.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $187.66 / $337.77 / $1,203.59	Professional		$187.66	$337.77	$1,203.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $135.04 / $252.00 / $399.09	Facility		$135.04	$252.00	$399.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $217.46 / $290.64 / $428.95	Professional		$217.46	$290.64	$428.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.29 / $181.32 / $304.75	Professional		$107.29	$181.32	$304.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,151.00 / $1,640.00 / $3,560.25	Facility		$1,151.00	$1,640.00	$3,560.25
United Facility/Professional Professional Modifier Low / Median / High Price $168.60 / $302.02 / $477.26	Professional		$168.60	$302.02	$477.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $206.20 / $242.50 / $360.50	Professional		$206.20	$242.50	$360.50