Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,753.25 / $5,356.18 / $7,492.08	Facility		$2,753.25	$5,356.18	$7,492.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,817.15 / $2,120.00 / $2,395.33	Professional		$1,817.15	$2,120.00	$2,395.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,303.90 / $5,001.10 / $6,251.38	Professional		$3,303.90	$5,001.10	$6,251.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,340.26 / $3,716.89 / $14,072.16	Professional		$2,340.26	$3,716.89	$14,072.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,753.25 / $3,552.89 / $7,048.32	Facility		$2,753.25	$3,552.89	$7,048.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,651.95 / $1,847.43 / $10,344.70	Professional		$1,651.95	$1,847.43	$10,344.70
Midlands Facility/Professional Facility Modifier Low / Median / High Price $3,303.90 / $4,180.45 / $6,033.98	Facility		$3,303.90	$4,180.45	$6,033.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $3,303.90 / $5,035.01 / $7,185.98	Professional		$3,303.90	$5,035.01	$7,185.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,753.25 / $2,753.25 / $4,914.55	Professional		$2,753.25	$2,753.25	$4,914.55
United Facility/Professional Professional Modifier Low / Median / High Price $1,651.95 / $1,651.95 / $5,637.28	Professional		$1,651.95	$1,651.95	$5,637.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,753.25 / $2,753.25 / $2,753.25	Professional		$2,753.25	$2,753.25	$2,753.25