Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.89 / $2,633.35 / $5,549.00	Facility		$217.89	$2,633.35	$5,549.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,777.21 / $2,253.00 / $3,439.50	Facility	50	$1,777.21	$2,253.00	$3,439.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.29 / $171.49 / $478.03	Professional		$87.29	$171.49	$478.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $123.81 / $277.02 / $904.86	Professional	50	$123.81	$277.02	$904.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.63 / $336.59 / $516.15	Professional		$197.63	$336.59	$516.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.68 / $212.80 / $657.21	Professional		$83.68	$212.80	$657.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $168.77 / $306.52 / $2,166.60	Facility		$168.77	$306.52	$2,166.60
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,244.00 / $1,244.00 / $1,540.88	Facility	50	$1,244.00	$1,244.00	$1,540.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $182.50 / $341.34 / $776.25	Professional		$182.50	$341.34	$776.25
Midlands Facility/Professional Facility Modifier Low / Median / High Price $200.66 / $387.18 / $917.51	Facility		$200.66	$387.18	$917.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $198.70 / $321.57 / $478.13	Professional		$198.70	$321.57	$478.13
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $472.98 / $472.98 / $472.98	Facility		$472.98	$472.98	$472.98
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 $172.42 / $262.74 / $534.54	Professional		$172.42	$262.74	$534.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $175.20 / $269.70 / $401.70	Professional		$175.20	$269.70	$401.70