Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.63 / $2,301.00 / $6,298.62	Facility		$229.63	$2,301.00	$6,298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.40 / $189.37 / $463.44	Professional		$78.40	$189.37	$463.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $653.61 / $653.61 / $653.61	Professional	50	$653.61	$653.61	$653.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.91 / $374.11 / $662.24	Professional		$160.91	$374.11	$662.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $84.91 / $295.33 / $716.60	Professional		$84.91	$295.33	$716.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $137.19 / $339.91 / $1,970.00	Facility		$137.19	$339.91	$1,970.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $202.89 / $380.24 / $1,584.96	Professional		$202.89	$380.24	$1,584.96
Midlands Facility/Professional Facility Modifier Low / Median / High Price $184.99 / $463.35 / $917.51	Facility		$184.99	$463.35	$917.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $164.22 / $362.86 / $578.87	Professional		$164.22	$362.86	$578.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.04 / $223.24 / $961.36	Professional		$81.04	$223.24	$961.36
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 $208.80 / $322.58 / $607.10	Professional		$208.80	$322.58	$607.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $163.60 / $342.70 / $510.40	Professional		$163.60	$342.70	$510.40