Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $120.23 / $346.74	Facility		$54.95	$120.23	$346.74
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $69.18 / $234.42 / $354.81	Facility	25	$69.18	$234.42	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $85.11 / $213.80	Professional		$50.12	$85.11	$213.80
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $48.98 / $87.10 / $218.78	Professional	25	$48.98	$87.10	$218.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $257.04 / $269.15 / $269.15	Professional	50	$257.04	$269.15	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $97.72 / $208.93	Professional		$52.48	$97.72	$208.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $104.71 / $173.78	Professional		$61.66	$104.71	$173.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $77.62 / $134.90	Facility		$48.98	$77.62	$134.90
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $151.36 / $186.21 / $186.21	Facility	62	$151.36	$186.21	$186.21
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $23.99 / $29.51 / $29.51	Facility	AS	$23.99	$29.51	$29.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $416.87	Professional		$70.79	$134.90	$416.87
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $100.00 / $144.54 / $213.80	Professional	25	$100.00	$144.54	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $177.83	Professional		$95.50	$134.90	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $144.54 / $204.17	Professional		$72.44	$144.54	$204.17
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $91.20 / $954.99	Facility		$83.18	$91.20	$954.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $107.15 / $199.53	Professional		$60.26	$107.15	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $91.20	Facility		$63.10	$63.10	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $77.62 / $131.83	Professional		$50.12	$77.62	$131.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $102.33 / $128.82	Professional		$79.43	$102.33	$128.82