Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $495.42 / $3,496.00 / $6,723.84	Facility		$495.42	$3,496.00	$6,723.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,877.40 / $3,109.50 / $5,097.50	Facility	50	$1,877.40	$3,109.50	$5,097.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.09 / $260.75 / $865.00	Professional		$154.09	$260.75	$865.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $256.68 / $671.12 / $1,302.00	Professional	50	$256.68	$671.12	$1,302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.98 / $396.82 / $458.70	Professional		$352.98	$396.82	$458.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $145.91 / $253.17 / $459.10	Professional		$145.91	$253.17	$459.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $295.87 / $448.65 / $5,023.00	Facility		$295.87	$448.65	$5,023.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $186.79 / $1,569.21 / $2,033.43	Facility	50	$186.79	$1,569.21	$2,033.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.09 / $359.39 / $1,429.86	Professional		$190.09	$359.39	$1,429.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $282.00 / $471.93 / $1,300.32	Facility		$282.00	$471.93	$1,300.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $258.00 / $352.98 / $471.93	Professional		$258.00	$352.98	$471.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $298.70 / $412.00	Professional		$4.00	$298.70	$412.00
United Facility/Professional Facility Modifier Low / Median / High Price $3,044.00 / $5,023.00 / $7,305.00	Facility		$3,044.00	$5,023.00	$7,305.00
United Facility/Professional Professional Modifier Low / Median / High Price $170.79 / $284.08 / $483.44	Professional		$170.79	$284.08	$483.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $305.80 / $305.80 / $359.70	Professional		$305.80	$305.80	$359.70