Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.90 / $2,373.00 / $6,446.00	Facility		$138.90	$2,373.00	$6,446.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $543.25 / $543.25 / $543.25	Facility	50	$543.25	$543.25	$543.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $104.72 / $289.64	Professional		$67.27	$104.72	$289.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $81.23 / $319.80 / $778.50	Professional	50	$81.23	$319.80	$778.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.97 / $141.21 / $209.38	Professional		$112.97	$141.21	$209.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $108.80 / $298.95	Professional		$51.00	$108.80	$298.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.11 / $169.73 / $758.10	Facility		$73.11	$169.73	$758.10
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $748.46 / $748.46 / $748.46	Facility	50	$748.46	$748.46	$748.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.70 / $161.19 / $728.16	Professional		$80.70	$161.19	$728.16
Midlands Facility/Professional Facility Modifier Low / Median / High Price $59.98 / $136.58 / $215.78	Facility		$59.98	$136.58	$215.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $115.72 / $165.22 / $226.68	Professional		$115.72	$165.22	$226.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $86.74 / $145.85	Professional		$52.92	$86.74	$145.85
United Facility/Professional Facility Modifier Low / Median / High Price $1,151.00 / $1,775.00 / $3,560.25	Facility		$1,151.00	$1,775.00	$3,560.25
United Facility/Professional Professional Modifier Low / Median / High Price $70.97 / $125.76 / $218.92	Professional		$70.97	$125.76	$218.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $102.00 / $120.00 / $171.40	Professional		$102.00	$120.00	$171.40