Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $378.00 / $2,912.34 / $7,119.04	Facility		$378.00	$2,912.34	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.48 / $124.89 / $289.64	Professional		$67.48	$124.89	$289.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $326.91 / $326.91 / $326.91	Professional	50	$326.91	$326.91	$326.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.83 / $178.42 / $263.75	Professional		$120.83	$178.42	$263.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $55.22 / $121.37 / $393.55	Professional		$55.22	$121.37	$393.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.06 / $194.72 / $1,724.14	Facility		$80.06	$194.72	$1,724.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $96.97 / $193.34 / $1,010.08	Professional		$96.97	$193.34	$1,010.08
Midlands Facility/Professional Facility Modifier Low / Median / High Price $74.02 / $161.40 / $263.75	Facility		$74.02	$161.40	$263.75
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.16 / $193.29 / $274.82	Professional		$128.16	$193.29	$274.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.15 / $94.30 / $158.85	Professional		$53.15	$94.30	$158.85
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 $84.85 / $160.66 / $263.06	Professional		$84.85	$160.66	$263.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $106.50 / $130.82 / $194.80	Professional		$106.50	$130.82	$194.80