Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.47 / $154.72 / $5,091.00	Facility		$51.47	$154.72	$5,091.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $51.47 / $51.47 / $330.63	Facility	50	$51.47	$51.47	$330.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $63.37 / $206.00	Professional		$32.04	$63.37	$206.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $78.77 / $236.44 / $396.00	Professional	50	$78.77	$236.44	$396.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.00 / $38.61 / $94.88	Professional	52	$22.00	$38.61	$94.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.86 / $109.55 / $137.32	Professional		$69.86	$109.55	$137.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $29.74 / $67.92 / $133.09	Professional		$29.74	$67.92	$133.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.92 / $105.92 / $1,204.00	Facility		$70.92	$105.92	$1,204.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $116.25 / $116.25 / $116.25	Facility	52	$116.25	$116.25	$116.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.17 / $105.22 / $356.96	Professional		$60.17	$105.22	$356.96
Midlands Facility/Professional Facility Modifier Low / Median / High Price $69.86 / $100.39 / $136.31	Facility		$69.86	$100.39	$136.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $67.68 / $90.69 / $127.31	Professional		$67.68	$90.69	$127.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $96.10 / $121.90	Professional		$4.00	$96.10	$121.90
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 $52.04 / $96.38 / $152.32	Professional		$52.04	$96.38	$152.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $60.50 / $71.20 / $106.80	Professional		$60.50	$71.20	$106.80