Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $2,290.87 / $5,011.87	Facility		$128.82	$2,290.87	$5,011.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $954.99 / $2,238.72 / $3,548.13	Facility	50	$954.99	$2,238.72	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $194.98 / $812.83	Professional		$85.11	$194.98	$812.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $436.52 / $1,230.27	Professional	50	$125.89	$436.52	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $263.03 / $524.81	Professional		$177.83	$263.03	$524.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $208.93 / $660.69	Professional		$91.20	$208.93	$660.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $363.08 / $2,951.21	Facility		$165.96	$363.08	$2,951.21
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,230.27 / $1,230.27 / $1,548.82	Facility	50	$1,230.27	$1,230.27	$1,548.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $338.84 / $776.25	Professional		$181.97	$338.84	$776.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $323.59 / $457.09	Professional		$208.93	$323.59	$457.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $338.84 / $446.68	Professional		$181.97	$338.84	$446.68
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Facility		$467.74	$467.74	$467.74
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 $93.33 / $194.98 / $457.09	Professional		$93.33	$194.98	$457.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $269.15 / $398.11	Professional		$173.78	$269.15	$398.11