Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.16 / $1,788.08 / $5,549.00	Facility		$161.16	$1,788.08	$5,549.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $111.05 / $697.01 / $4,180.05	Facility	50	$111.05	$697.01	$4,180.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.85 / $177.67 / $439.45	Professional		$54.85	$177.67	$439.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $83.33 / $312.57 / $1,255.32	Professional	50	$83.33	$312.57	$1,255.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.70 / $317.64 / $637.23	Professional		$112.70	$317.64	$637.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.68 / $275.11 / $556.09	Professional		$54.68	$275.11	$556.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.01 / $297.58 / $655.43	Facility		$95.01	$297.58	$655.43
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $2,730.30 / $2,730.30 / $2,730.30	Facility	50	$2,730.30	$2,730.30	$2,730.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $157.05 / $334.57 / $894.79	Professional		$157.05	$334.57	$894.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $112.70 / $376.26 / $589.17	Facility		$112.70	$376.26	$589.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.10 / $334.57 / $589.17	Professional		$114.10	$334.57	$589.17
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,042.42 / $2,042.42 / $2,042.42	Facility		$2,042.42	$2,042.42	$2,042.42
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 $169.46 / $279.79 / $525.37	Professional		$169.46	$279.79	$525.37
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.90 / $354.87 / $528.50	Professional		$112.90	$354.87	$528.50