Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $301.66 / $2,218.00 / $5,253.32	Facility		$301.66	$2,218.00	$5,253.32
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $901.89 / $2,951.73 / $4,422.80	Facility	50	$901.89	$2,951.73	$4,422.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.84 / $261.58 / $668.30	Professional		$102.84	$261.58	$668.30
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.52 / $141.52 / $191.19	Professional	22	$141.52	$141.52	$191.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $150.56 / $405.48 / $2,125.50	Professional	50	$150.56	$405.48	$2,125.50
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $20.57 / $45.88 / $71.39	Professional	53	$20.57	$45.88	$71.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.35 / $428.46 / $712.88	Professional		$242.35	$428.46	$712.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $106.40 / $319.45 / $752.56	Professional		$106.40	$319.45	$752.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $177.82 / $510.98 / $1,996.86	Facility		$177.82	$510.98	$1,996.86
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $961.00 / $961.00 / $2,515.88	Facility	50	$961.00	$961.00	$2,515.88
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $100.82 / $100.82 / $100.82	Facility	53	$100.82	$100.82	$100.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $245.88 / $491.77 / $2,376.04	Professional		$245.88	$491.77	$2,376.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $255.53 / $608.30 / $921.98	Facility		$255.53	$608.30	$921.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $242.35 / $446.40 / $641.55	Professional		$242.35	$446.40	$641.55
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $478.06 / $478.06 / $478.06	Facility		$478.06	$478.06	$478.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $106.07 / $244.67 / $961.36	Professional		$106.07	$244.67	$961.36
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 $234.71 / $363.55 / $670.59	Professional		$234.71	$363.55	$670.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $213.70 / $370.12 / $551.10	Professional		$213.70	$370.12	$551.10