Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $1,288.25 / $5,011.87	Facility		$74.13	$1,288.25	$5,011.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $891.25 / $1,148.15 / $1,905.46	Facility	50	$891.25	$1,148.15	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $112.20 / $602.56	Professional		$48.98	$112.20	$602.56
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $218.78 / $741.31	Professional	50	$72.44	$218.78	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $165.96 / $269.15	Professional		$100.00	$165.96	$269.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $109.65 / $501.19	Professional		$51.29	$109.65	$501.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $138.04 / $1,348.96	Facility		$75.86	$138.04	$1,348.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $169.82 / $478.63	Professional		$93.33	$169.82	$478.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $165.96 / $239.88	Professional		$109.65	$165.96	$239.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $169.82 / $229.09	Professional		$100.00	$169.82	$229.09
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,621.81 / $3,548.13	Facility		$1,148.15	$1,621.81	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $104.71 / $229.09	Professional		$53.70	$104.71	$229.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $138.04 / $204.17	Professional		$97.72	$138.04	$204.17