Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $893.00 / $2,912.34 / $7,119.04	Facility		$893.00	$2,912.34	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.74 / $89.35 / $695.16	Professional		$57.74	$89.35	$695.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.27 / $157.62 / $194.57	Professional		$135.27	$157.62	$194.57
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.74 / $103.53 / $929.94	Professional		$61.74	$103.53	$929.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $89.35 / $215.04 / $2,710.90	Facility		$89.35	$215.04	$2,710.90
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $2,055.60 / $2,055.60 / $2,055.60	Facility	52	$2,055.60	$2,055.60	$2,055.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.87 / $153.72 / $1,398.72	Professional		$69.87	$153.72	$1,398.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $141.93 / $187.71 / $921.98	Facility		$141.93	$187.71	$921.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $118.22 / $161.77 / $200.40	Professional		$118.22	$161.77	$200.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $115.56 / $984.88	Professional		$63.57	$115.56	$984.88
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 $63.80 / $124.53 / $201.12	Professional		$63.80	$124.53	$201.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $98.83 / $125.10 / $147.19	Professional		$98.83	$125.10	$147.19