Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,897.00 / $3,690.43 / $5,162.08	Facility		$1,897.00	$3,690.43	$5,162.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,252.02 / $1,650.39 / $1,840.09	Professional		$1,252.02	$1,650.39	$1,840.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,276.40 / $3,446.13 / $4,307.66	Professional		$2,276.40	$3,446.13	$4,307.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,612.45 / $2,560.94 / $9,695.77	Professional		$1,612.45	$2,560.94	$9,695.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,897.00 / $2,447.94 / $4,856.32	Facility		$1,897.00	$2,447.94	$4,856.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,138.20 / $1,272.89 / $7,127.54	Professional		$1,138.20	$1,272.89	$7,127.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,276.40 / $2,880.35 / $4,157.43	Facility		$2,276.40	$2,880.35	$4,157.43
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,276.40 / $3,469.14 / $4,951.17	Professional		$2,276.40	$3,469.14	$4,951.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,897.00 / $1,897.00 / $3,386.14	Professional		$1,897.00	$1,897.00	$3,386.14
United Facility/Professional Professional Modifier Low / Median / High Price $1,138.20 / $1,138.20 / $3,884.11	Professional		$1,138.20	$1,138.20	$3,884.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,897.00 / $1,897.00 / $1,897.00	Professional		$1,897.00	$1,897.00	$1,897.00