Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $603.00 / $3,259.25 / $7,119.04	Facility		$603.00	$3,259.25	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.17 / $205.19 / $865.00	Professional		$115.17	$205.19	$865.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $172.76 / $234.60 / $1,218.00	Professional	50	$172.76	$234.60	$1,218.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.25 / $311.06 / $419.74	Professional		$137.25	$311.06	$419.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.70 / $171.12 / $313.70	Professional		$104.70	$171.12	$313.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $201.25 / $340.84 / $1,371.00	Facility		$201.25	$340.84	$1,371.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $168.77 / $302.33 / $876.88	Professional		$168.77	$302.33	$876.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $149.97 / $274.27 / $361.72	Facility		$149.97	$274.27	$361.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $229.11 / $306.47 / $390.32	Professional		$229.11	$306.47	$390.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.03 / $190.09 / $256.11	Professional		$108.03	$190.09	$256.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,623.00 / $2,126.00	Facility		$1,204.00	$1,623.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $154.69 / $231.40 / $430.69	Professional		$154.69	$231.40	$430.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $213.70 / $258.89 / $318.20	Professional		$213.70	$258.89	$318.20