Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $2,290.87 / $6,760.83	Facility		$123.03	$2,290.87	$6,760.83
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $281.84 / $1,318.26 / $1,318.26	Facility	50	$281.84	$1,318.26	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $89.13 / $295.12	Professional		$50.12	$89.13	$295.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $288.40 / $501.19	Professional	50	$79.43	$288.40	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $269.15	Professional		$102.33	$147.91	$269.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $109.65 / $512.86	Professional		$51.29	$109.65	$512.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $141.25 / $1,348.96	Facility		$75.86	$141.25	$1,348.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $169.82 / $389.05	Professional		$93.33	$169.82	$389.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $239.88	Professional		$112.20	$169.82	$239.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $169.82 / $229.09	Professional		$102.33	$169.82	$229.09
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
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 $54.95 / $104.71 / $229.09	Professional		$54.95	$104.71	$229.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $204.17	Professional		$97.72	$134.90	$204.17