Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,906.00 / $4,235.59 / $7,119.04	Facility		$2,906.00	$4,235.59	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.62 / $140.85 / $227.57	Professional		$73.62	$140.85	$227.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.00 / $212.40 / $365.20	Professional		$131.00	$212.40	$365.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $65.26 / $163.89 / $950.00	Professional		$65.26	$163.89	$950.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $113.05 / $224.39 / $556.97	Facility		$113.05	$224.39	$556.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $143.66 / $275.11 / $565.50	Professional		$143.66	$275.11	$565.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $131.00 / $275.11 / $364.73	Facility		$131.00	$275.11	$364.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.53 / $258.43 / $392.74	Professional		$134.53	$258.43	$392.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $114.69 / $240.50	Professional		$60.28	$114.69	$240.50
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,640.00 / $2,126.00	Facility		$1,204.00	$1,640.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $137.13 / $210.40 / $425.17	Professional		$137.13	$210.40	$425.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $115.50 / $191.65 / $285.39	Professional		$115.50	$191.65	$285.39