Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.39 / $925.12 / $3,690.00	Facility		$269.39	$925.12	$3,690.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.12 / $240.85 / $590.87	Professional		$94.12	$240.85	$590.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $224.38 / $477.71 / $745.01	Professional		$224.38	$477.71	$745.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $105.33 / $302.63 / $839.99	Professional		$105.33	$302.63	$839.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $164.79 / $432.21 / $1,778.52	Facility		$164.79	$432.21	$1,778.52
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $89.92 / $89.92 / $89.92	Facility	53	$89.92	$89.92	$89.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $249.94 / $477.71 / $970.67	Professional		$249.94	$477.71	$970.67
Midlands Facility/Professional Facility Modifier Low / Median / High Price $225.63 / $555.13 / $722.77	Facility		$225.63	$555.13	$722.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $225.63 / $452.12 / $714.91	Professional		$225.63	$452.12	$714.91
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $708.02 / $708.02 / $708.02	Facility		$708.02	$708.02	$708.02
United Facility/Professional Facility Modifier Low / Median / High Price $1,775.00 / $3,482.00 / $5,454.00	Facility		$1,775.00	$3,482.00	$5,454.00
United Facility/Professional Professional Modifier Low / Median / High Price $249.94 / $386.45 / $786.25	Professional		$249.94	$386.45	$786.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $190.60 / $386.86 / $576.10	Professional		$190.60	$386.86	$576.10