Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $3,019.95 / $6,456.54	Facility		$354.81	$3,019.95	$6,456.54
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility	50	$1,380.38	$1,380.38	$1,380.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $371.54 / $1,047.13	Professional		$218.78	$371.54	$1,047.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $501.19 / $758.58 / $1,862.09	Professional	50	$501.19	$758.58	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $524.81 / $724.44	Professional		$234.42	$524.81	$724.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $295.12 / $870.96	Professional		$177.83	$295.12	$870.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $691.83 / $3,235.94	Facility		$371.54	$691.83	$3,235.94
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $645.65 / $645.65 / $645.65	Facility	54	$645.65	$645.65	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $575.44 / $3,715.35	Professional		$316.23	$575.44	$3,715.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $537.03 / $724.44	Professional		$478.63	$537.03	$724.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Professional		$489.78	$489.78	$489.78
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $316.23 / $512.86	Professional		$173.78	$316.23	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,949.84 / $4,897.79	Facility		$1,023.29	$1,949.84	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $389.05 / $691.83	Professional		$239.88	$389.05	$691.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $446.68 / $537.03	Professional		$363.08	$446.68	$537.03