Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $182.76 / $2,352.00 / $6,298.62	Facility		$182.76	$2,352.00	$6,298.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $138.72 / $138.72 / $4,696.64	Facility	50	$138.72	$138.72	$4,696.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.98 / $197.19 / $418.48	Professional		$62.98	$197.19	$418.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $95.36 / $161.90 / $796.95	Professional	50	$95.36	$161.90	$796.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.69 / $208.55 / $649.73	Professional		$127.69	$208.55	$649.73
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $62.14 / $293.54 / $648.33	Professional		$62.14	$293.54	$648.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.73 / $330.66 / $728.31	Facility		$107.73	$330.66	$728.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $174.83 / $367.73 / $954.56	Professional		$174.83	$367.73	$954.56
Midlands Facility/Professional Facility Modifier Low / Median / High Price $127.69 / $418.09 / $627.78	Facility		$127.69	$418.09	$627.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $130.32 / $367.73 / $627.78	Professional		$130.32	$367.73	$627.78
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $934.10 / $934.10 / $934.10	Facility		$934.10	$934.10	$934.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,640.00 / $2,126.00	Facility		$1,204.00	$1,640.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $185.99 / $315.17 / $580.99	Professional		$185.99	$315.17	$580.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $128.30 / $378.17 / $563.20	Professional		$128.30	$378.17	$563.20