Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $872.13 / $4,604.83 / $8,786.62	Facility		$872.13	$4,604.83	$8,786.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.76 / $469.82 / $1,625.86	Professional		$266.76	$469.82	$1,625.86
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $55.70 / $283.33 / $439.17	Professional	53	$55.70	$283.33	$439.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $442.98 / $960.84 / $3,664.69	Professional		$442.98	$960.84	$3,664.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $214.29 / $707.05 / $2,033.68	Professional		$214.29	$707.05	$2,033.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $428.87 / $1,625.86 / $7,131.46	Facility		$428.87	$1,625.86	$7,131.46
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $840.46 / $840.46 / $840.46	Facility	52	$840.46	$840.46	$840.46
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $210.11 / $210.11 / $210.11	Facility	53	$210.11	$210.11	$210.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $501.00 / $2,079.04 / $9,714.64	Professional		$501.00	$2,079.04	$9,714.64
Midlands Facility/Professional Facility Modifier Low / Median / High Price $534.91 / $2,617.31 / $3,348.52	Facility		$534.91	$2,617.31	$3,348.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $442.98 / $960.84 / $3,313.47	Professional		$442.98	$960.84	$3,313.47
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,112.28 / $17,216.05 / $29,736.79	Facility		$3,112.28	$17,216.05	$29,736.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $227.37 / $1,123.58 / $3,441.55	Professional		$227.37	$1,123.58	$3,441.55
United Facility/Professional Facility Modifier Low / Median / High Price $4,217.00 / $5,732.00 / $8,342.00	Facility		$4,217.00	$5,732.00	$8,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $516.66 / $2,079.04 / $4,229.93	Professional		$516.66	$2,079.04	$4,229.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $437.50 / $514.70 / $2,768.00	Professional		$437.50	$514.70	$2,768.00