Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $2,238.72 / $6,025.60	Facility		$190.55	$2,238.72	$6,025.60
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,677.35 / $4,677.35 / $4,677.35	Facility	50	$4,677.35	$4,677.35	$4,677.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $251.19 / $794.33	Professional		$64.57	$251.19	$794.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $162.18 / $616.60	Professional	50	$95.50	$162.18	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $724.44	Professional		$128.82	$190.55	$724.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $295.12 / $645.65	Professional		$67.61	$295.12	$645.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $331.13 / $1,380.38	Facility		$100.00	$331.13	$1,380.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $363.08 / $954.99	Professional		$165.96	$363.08	$954.99
Midlands Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $416.87 / $645.65	Professional		$158.49	$416.87	$645.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $363.08 / $645.65	Professional		$128.82	$363.08	$645.65
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
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 $72.44 / $186.21 / $489.78	Professional		$72.44	$186.21	$489.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $380.19 / $562.34	Professional		$128.82	$380.19	$562.34