Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $451.90 / $2,352.00 / $6,298.62	Facility		$451.90	$2,352.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.40 / $157.31 / $468.00	Professional		$83.40	$157.31	$468.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $38.11 / $61.77 / $297.45	Professional	52	$38.11	$61.77	$297.45
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $15.25 / $24.71 / $118.97	Professional	53	$15.25	$24.71	$118.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.12 / $219.06 / $283.39	Professional		$137.12	$219.06	$283.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.66 / $142.91 / $286.23	Professional		$58.66	$142.91	$286.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.41 / $238.81 / $1,151.00	Facility		$117.41	$238.81	$1,151.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $228.87 / $228.87 / $228.87	Facility	52	$228.87	$228.87	$228.87
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $57.22 / $57.22 / $57.22	Facility	53	$57.22	$57.22	$57.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $133.84 / $219.06 / $753.20	Professional		$133.84	$219.06	$753.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $85.39 / $165.65 / $262.66	Facility		$85.39	$165.65	$262.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $137.54 / $196.06 / $274.13	Professional		$137.54	$196.06	$274.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $107.82 / $192.46	Professional		$62.23	$107.82	$192.46
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 $109.82 / $196.11 / $300.79	Professional		$109.82	$196.11	$300.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $119.20 / $140.19 / $223.30	Professional		$119.20	$140.19	$223.30