Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $407.38 / $6,760.83	Facility		$91.20	$407.38	$6,760.83
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $0.52 / $0.52 / $0.52	Facility	50	$0.52	$0.52	$0.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $128.82 / $549.54	Professional		$58.88	$128.82	$549.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $338.84 / $831.76 / $1,071.52	Professional	50	$338.84	$831.76	$1,071.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $234.42 / $346.74	Professional		$120.23	$234.42	$346.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $138.04 / $724.44	Professional		$63.10	$138.04	$724.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $218.78 / $2,089.30	Facility		$97.72	$218.78	$2,089.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $186.21 / $912.01	Professional		$91.20	$186.21	$912.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $295.12	Professional		$131.83	$181.97	$295.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $234.42 / $295.12	Professional		$125.89	$234.42	$295.12
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $12,022.64 / $15,848.93 / $44,668.36	Facility		$12,022.64	$15,848.93	$44,668.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $134.90 / $275.42	Professional		$63.10	$134.90	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $2,290.87 / $4,897.79	Facility		$1,513.56	$2,290.87	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $109.65 / $234.42	Professional		$57.54	$109.65	$234.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $177.83 / $263.03	Professional		$123.03	$177.83	$263.03