Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $2,290.87 / $6,456.54	Facility		$141.25	$2,290.87	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $125.89 / $426.58	Professional		$52.48	$125.89	$426.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $446.68 / $794.33 / $1,548.82	Professional	50	$446.68	$794.33	$1,548.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $218.78 / $288.40	Professional		$125.89	$218.78	$288.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $131.83 / $537.03	Professional		$57.54	$131.83	$537.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $234.42 / $2,951.21	Facility		$95.50	$234.42	$2,951.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $218.78 / $1,071.52	Professional		$102.33	$218.78	$1,071.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $229.09 / $331.13	Professional		$134.90	$229.09	$331.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $269.15 / $269.15	Professional		$158.49	$269.15	$269.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $100.00 / $199.53	Professional		$51.29	$100.00	$199.53
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 $61.66 / $128.82 / $251.19	Professional		$61.66	$128.82	$251.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $218.78	Professional		$104.71	$147.91	$218.78