Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.00 / $185.55 / $5,549.00	Facility		$22.00	$185.55	$5,549.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $24.41 / $56.82	Professional		$12.49	$24.41	$56.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.89 / $52.92 / $105.00	Professional	50	$17.89	$52.92	$105.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $7.01 / $12.21 / $38.47	Professional	52	$7.01	$12.21	$38.47
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $4.88 / $4.88 / $19.32	Professional	53	$4.88	$4.88	$19.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.69 / $38.57 / $45.77	Professional		$29.69	$38.57	$45.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $15.94 / $23.81 / $43.15	Professional		$15.94	$23.81	$43.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $14.82 / $40.04 / $1,607.00	Facility		$14.82	$40.04	$1,607.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.50 / $31.27 / $71.17	Professional		$15.50	$31.27	$71.17
Midlands Facility/Professional Facility Modifier Low / Median / High Price $18.69 / $29.69 / $41.01	Facility		$18.69	$29.69	$41.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $21.98 / $30.49 / $43.77	Professional		$21.98	$30.49	$43.77
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $138.56 / $138.56 / $138.56	Facility		$138.56	$138.56	$138.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $17.50 / $41.80	Professional		$17.50	$17.50	$41.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,607.00 / $2,126.00	Facility		$1,204.00	$1,607.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $14.86 / $27.86 / $42.06	Professional		$14.86	$27.86	$42.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $29.60 / $29.60 / $34.90	Professional		$29.60	$29.60	$34.90