Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $545.57 / $2,977.00 / $6,298.62	Facility		$545.57	$2,977.00	$6,298.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $733.78 / $879.69 / $879.69	Facility	50	$733.78	$879.69	$879.69
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $682.48 / $682.48 / $682.48	Facility	54	$682.48	$682.48	$682.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $289.27 / $396.66 / $1,105.71	Professional		$289.27	$396.66	$1,105.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $428.58 / $916.41 / $2,308.50	Professional	50	$428.58	$916.41	$2,308.50
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $216.72 / $406.52 / $436.79	Professional	54	$216.72	$406.52	$436.79
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $43.34 / $81.30 / $87.36	Professional	55	$43.34	$81.30	$87.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.27 / $719.80 / $962.19	Professional		$264.27	$719.80	$962.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $240.04 / $396.17 / $730.68	Professional		$240.04	$396.17	$730.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $489.00 / $825.08 / $3,258.00	Facility		$489.00	$825.08	$3,258.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $361.84 / $719.48 / $2,322.88	Professional		$361.84	$719.48	$2,322.88
Medica Facility/Professional Professional Modifier 54 Low / Median / High Price $449.28 / $449.28 / $449.28	Professional	54	$449.28	$449.28	$449.28
Midlands Facility/Professional Facility Modifier Low / Median / High Price $474.18 / $672.48 / $941.02	Facility		$474.18	$672.48	$941.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $461.26 / $719.80 / $941.02	Professional		$461.26	$719.80	$941.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $286.64 / $521.66 / $615.23	Professional		$286.64	$521.66	$615.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,405.00 / $3,258.00 / $5,454.00	Facility		$1,405.00	$3,258.00	$5,454.00
United Facility/Professional Professional Modifier Low / Median / High Price $342.16 / $503.42 / $933.27	Professional		$342.16	$503.42	$933.27
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $492.57 / $637.40 / $733.50	Professional		$492.57	$637.40	$733.50