Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $3,793.54 / $5,306.30	Facility		$1,950.00	$3,793.54	$5,306.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,287.00 / $1,501.50 / $1,891.50	Professional		$1,287.00	$1,501.50	$1,891.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,341.94 / $3,541.44 / $4,426.80	Professional		$2,341.94	$3,541.44	$4,426.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,657.50 / $2,632.50 / $3,529.50	Professional		$1,657.50	$2,632.50	$3,529.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,950.00 / $2,516.34 / $4,992.00	Facility		$1,950.00	$2,516.34	$4,992.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,170.00 / $1,308.45 / $7,326.68	Professional		$1,170.00	$1,308.45	$7,326.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,340.00 / $2,730.00 / $4,273.59	Facility		$2,340.00	$2,730.00	$4,273.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,340.00 / $3,566.06 / $5,089.50	Professional		$2,340.00	$3,566.06	$5,089.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,897.35 / $1,950.00 / $3,480.75	Professional		$1,897.35	$1,950.00	$3,480.75
United Facility/Professional Professional Modifier Low / Median / High Price $1,170.00 / $1,170.00 / $3,607.50	Professional		$1,170.00	$1,170.00	$3,607.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,950.00 / $1,950.00 / $1,950.00	Professional		$1,950.00	$1,950.00	$1,950.00