Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $581.66 / $3,419.00 / $6,446.00	Facility		$581.66	$3,419.00	$6,446.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,376.78 / $1,376.78 / $1,376.78	Facility	50	$1,376.78	$1,376.78	$1,376.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.44 / $358.58 / $895.00	Professional		$228.44	$358.58	$895.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $501.82 / $522.73 / $2,233.42	Professional	50	$501.82	$522.73	$2,233.42
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $152.56 / $268.94 / $1,002.66	Professional	54	$152.56	$268.94	$1,002.66
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $28.61 / $53.79 / $64.34	Professional	55	$28.61	$53.79	$64.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.41 / $529.11 / $702.16	Professional		$251.41	$529.11	$702.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $176.90 / $294.44 / $788.60	Professional		$176.90	$294.44	$788.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $369.48 / $658.50 / $3,258.00	Facility		$369.48	$658.50	$3,258.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $281.83 / $568.39 / $3,680.00	Professional		$281.83	$568.39	$3,680.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $215.62 / $483.34 / $652.13	Facility		$215.62	$483.34	$652.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.96 / $571.03 / $725.76	Professional		$426.96	$571.03	$725.76
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $138.65 / $138.65 / $138.65	Facility		$138.65	$138.65	$138.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $184.90 / $300.18 / $439.56	Professional		$184.90	$300.18	$439.56
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 $258.36 / $375.79 / $764.57	Professional		$258.36	$375.79	$764.57
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $362.06 / $451.70 / $539.20	Professional		$362.06	$451.70	$539.20