Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.61 / $2,373.00 / $6,446.00	Facility		$161.61	$2,373.00	$6,446.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $116.08 / $1,575.00 / $3,611.00	Facility	50	$116.08	$1,575.00	$3,611.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.53 / $93.19 / $226.24	Professional		$57.53	$93.19	$226.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $92.15 / $217.51 / $491.63	Professional	50	$92.15	$217.51	$491.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.00 / $165.56 / $280.48	Professional		$119.00	$165.56	$280.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $55.26 / $119.22 / $512.64	Professional		$55.26	$119.22	$512.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.27 / $157.96 / $319.97	Facility		$95.27	$157.96	$319.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.66 / $187.58 / $575.00	Professional		$104.66	$187.58	$575.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $129.56 / $182.45 / $255.02	Facility		$129.56	$182.45	$255.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $119.00 / $182.15 / $263.19	Professional		$119.00	$182.15	$263.19
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $488.35 / $488.35 / $488.35	Facility		$488.35	$488.35	$488.35
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 $95.56 / $151.30 / $296.26	Professional		$95.56	$151.30	$296.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.20 / $148.52 / $221.20	Professional		$114.20	$148.52	$221.20