Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,740.00 / $3,385.00 / $4,734.85	Facility		$1,740.00	$3,385.00	$4,734.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,513.80 / $1,513.80 / $1,687.80	Professional		$1,513.80	$1,513.80	$1,687.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,089.71 / $3,160.20 / $3,950.26	Professional		$2,089.71	$3,160.20	$3,950.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,479.00 / $2,349.00 / $8,893.33	Professional		$1,479.00	$2,349.00	$8,893.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,740.00 / $2,245.35 / $4,454.39	Facility		$1,740.00	$2,245.35	$4,454.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,044.00 / $1,078.80 / $5,615.15	Professional		$1,044.00	$1,078.80	$5,615.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,088.00 / $2,644.80 / $3,584.40	Facility		$2,088.00	$2,644.80	$3,584.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,088.00 / $2,644.80 / $3,584.40	Professional		$2,088.00	$2,644.80	$3,584.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,740.00 / $1,740.00 / $3,105.90	Professional		$1,740.00	$1,740.00	$3,105.90
United Facility/Professional Professional Modifier Low / Median / High Price $1,044.00 / $1,044.00 / $3,562.65	Professional		$1,044.00	$1,044.00	$3,562.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,740.00 / $1,740.00 / $1,740.00	Professional		$1,740.00	$1,740.00	$1,740.00