Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,428.00 / $3,259.25 / $7,119.04	Facility		$1,428.00	$3,259.25	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.37 / $411.05 / $1,778.35	Professional		$240.37	$411.05	$1,778.35
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $481.37 / $2,667.53 / $2,704.50	Professional	50	$481.37	$2,667.53	$2,704.50
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $164.14 / $308.29 / $391.33	Professional	54	$164.14	$308.29	$391.33
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $32.83 / $61.66 / $78.27	Professional	55	$32.83	$61.66	$78.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.42 / $641.17 / $856.04	Professional		$276.42	$641.17	$856.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $211.48 / $353.50 / $1,018.26	Professional		$211.48	$353.50	$1,018.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $451.37 / $727.78 / $3,258.00	Facility		$451.37	$727.78	$3,258.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $340.76 / $632.48 / $1,266.15	Professional		$340.76	$632.48	$1,266.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $297.81 / $547.15 / $796.25	Facility		$297.81	$547.15	$796.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $472.64 / $641.17 / $818.64	Professional		$472.64	$641.17	$818.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $212.76 / $377.49 / $530.82	Professional		$212.76	$377.49	$530.82
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 $312.37 / $480.02 / $851.91	Professional		$312.37	$480.02	$851.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $438.77 / $518.40 / $653.40	Professional		$438.77	$518.40	$653.40