Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.28 / $414.00 / $6,446.00	Facility		$97.28	$414.00	$6,446.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.99 / $54.05 / $223.00	Professional		$29.99	$54.05	$223.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $333.00 / $333.00 / $333.00	Professional	50	$333.00	$333.00	$333.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $66.22 / $88.88	Professional		$34.47	$66.22	$88.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $26.04 / $36.86 / $140.84	Professional		$26.04	$36.86	$140.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.85 / $109.46 / $1,607.00	Facility		$61.85	$109.46	$1,607.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $87.10 / $217.84	Professional		$43.19	$87.10	$217.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $61.85 / $83.62 / $106.73	Facility		$61.85	$83.62	$106.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.85 / $86.46 / $111.99	Professional		$61.85	$86.46	$111.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.40 / $45.34 / $51.93	Professional		$25.40	$45.34	$51.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,623.00 / $2,126.00	Facility		$1,204.00	$1,623.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $39.59 / $67.30 / $130.06	Professional		$39.59	$67.30	$130.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $42.82 / $58.60 / $63.80	Professional		$42.82	$58.60	$63.80