Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,003.31 / $5,220.00 / $9,044.54	Facility		$2,003.31	$5,220.00	$9,044.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $424.94 / $784.91 / $2,785.46	Professional		$424.94	$784.91	$2,785.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $730.91 / $756.57 / $2,176.42	Professional	50	$730.91	$756.57	$2,176.42
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $252.19 / $473.83 / $473.83	Professional	52	$252.19	$473.83	$473.83
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $378.29 / $526.79 / $710.74	Professional	54	$378.29	$526.79	$710.74
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $49.00 / $92.47 / $185.94	Professional	55	$49.00	$92.47	$185.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $828.28 / $1,243.44 / $1,554.30	Professional		$828.28	$1,243.44	$1,554.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $393.46 / $684.50 / $1,749.30	Professional		$393.46	$684.50	$1,749.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,173.94 / $1,828.40 / $6,306.00	Facility		$1,173.94	$1,828.40	$6,306.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $625.39 / $1,258.01 / $2,578.56	Professional		$625.39	$1,258.01	$2,578.56
Medica Facility/Professional Professional Modifier 54 Low / Median / High Price $1,152.00 / $1,152.00 / $1,152.00	Professional	54	$1,152.00	$1,152.00	$1,152.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,158.00 / $1,671.29 / $2,428.62	Facility		$1,158.00	$1,671.29	$2,428.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $983.58 / $1,317.24 / $1,641.42	Professional		$983.58	$1,317.24	$1,641.42
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,118.48 / $3,879.81 / $6,701.49	Facility		$1,118.48	$3,879.81	$6,701.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $483.74 / $901.60 / $2,502.31	Professional		$483.74	$901.60	$2,502.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,405.00 / $5,854.53 / $7,407.10	Facility		$1,405.00	$5,854.53	$7,407.10
United Facility/Professional Professional Modifier Low / Median / High Price $573.28 / $951.06 / $1,696.53	Professional		$573.28	$951.06	$1,696.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $803.35 / $1,112.59 / $1,196.40	Professional		$803.35	$1,112.59	$1,196.40