Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.00 / $1,897.82 / $6,298.62	Facility		$199.00	$1,897.82	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.18 / $141.27 / $393.68	Professional		$68.18	$141.27	$393.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $342.67 / $342.67 / $768.00	Professional	50	$342.67	$342.67	$768.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.07 / $262.29 / $452.85	Professional		$137.07	$262.29	$452.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $71.87 / $207.08 / $552.63	Professional		$71.87	$207.08	$552.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.31 / $236.68 / $1,724.14	Facility		$117.31	$236.68	$1,724.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.07 / $270.66 / $1,087.00	Professional		$137.07	$270.66	$1,087.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $140.90 / $206.23 / $391.60	Facility		$140.90	$206.23	$391.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $140.90 / $262.29 / $392.11	Professional		$140.90	$262.29	$392.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $159.29 / $295.38	Professional		$70.73	$159.29	$295.38
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 $124.58 / $189.84 / $379.96	Professional		$124.58	$189.84	$379.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $138.60 / $237.24 / $353.30	Professional		$138.60	$237.24	$353.30