Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $1,905.46 / $5,248.07	Facility		$245.47	$1,905.46	$5,248.07
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,137.96 / $2,951.21 / $4,466.84	Facility	50	$2,137.96	$2,951.21	$4,466.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $331.13 / $1,230.27	Professional		$104.71	$331.13	$1,230.27
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $190.55 / $1,548.82	Professional	22	$141.25	$190.55	$1,548.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $630.96 / $2,089.30	Professional	50	$151.36	$630.96	$2,089.30
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $51.29 / $97.72 / $186.21	Professional	53	$51.29	$97.72	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $323.59 / $724.44	Professional		$223.87	$323.59	$724.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $281.84 / $794.33	Professional		$104.71	$281.84	$794.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $512.86 / $2,951.21	Facility		$165.96	$512.86	$2,951.21
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $954.99 / $954.99 / $2,511.89	Facility	50	$954.99	$954.99	$2,511.89
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	53	$100.00	$100.00	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $478.63 / $1,905.46	Professional		$239.88	$478.63	$1,905.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $537.03 / $645.65	Professional		$263.03	$537.03	$645.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $426.58 / $616.60	Professional		$223.87	$426.58	$616.60
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $239.88 / $537.03	Professional		$102.33	$239.88	$537.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,884.03 / $4,897.79	Facility		$1,621.81	$2,884.03	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $263.03 / $616.60	Professional		$114.82	$263.03	$616.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $371.54 / $549.54	Professional		$213.80	$371.54	$549.54