Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.23 / $1,955.39 / $5,549.00	Facility		$107.23	$1,955.39	$5,549.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,866.25 / $2,866.25 / $2,866.25	Facility	50	$2,866.25	$2,866.25	$2,866.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.06 / $97.83 / $289.64	Professional		$60.06	$97.83	$289.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $83.28 / $249.86 / $724.44	Professional	50	$83.28	$249.86	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.25 / $156.47 / $215.23	Professional		$90.25	$156.47	$215.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $41.47 / $99.33 / $293.49	Professional		$41.47	$99.33	$293.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.27 / $152.29 / $1,724.14	Facility		$67.27	$152.29	$1,724.14
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $236.87 / $236.87 / $748.46	Facility	50	$236.87	$236.87	$748.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.77 / $161.57 / $722.00	Professional		$86.77	$161.57	$722.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $76.73 / $111.68 / $222.84	Facility		$76.73	$111.68	$222.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $90.25 / $157.52 / $222.84	Professional		$90.25	$157.52	$222.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.70 / $76.58 / $138.22	Professional		$40.70	$76.58	$138.22
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 $75.93 / $129.72 / $235.39	Professional		$75.93	$129.72	$235.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.59 / $112.58 / $167.60	Professional		$79.59	$112.58	$167.60