Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $933.25 / $6,456.54	Facility		$100.00	$933.25	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $134.90 / $467.74	Professional		$64.57	$134.90	$467.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $537.03 / $537.03 / $549.54	Professional	50	$537.03	$537.03	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $398.11	Professional		$131.83	$199.53	$398.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $158.49 / $707.95	Professional		$72.44	$158.49	$707.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $263.03 / $2,951.21	Facility		$100.00	$263.03	$2,951.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $239.88 / $1,230.27	Professional		$123.03	$239.88	$1,230.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $263.03 / $338.84	Professional		$154.88	$263.03	$338.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $234.42 / $338.84	Professional		$123.03	$234.42	$338.84
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Facility		$3,388.44	$3,388.44	$3,388.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $151.36 / $323.59	Professional		$69.18	$151.36	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,884.03 / $4,897.79	Facility		$1,621.81	$2,884.03	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $302.00	Professional		$70.79	$134.90	$302.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $204.17 / $302.00	Professional		$134.90	$204.17	$302.00