Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $2,884.03 / $4,168.69	Facility		$1,174.90	$2,884.03	$4,168.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,202.26 / $1,513.56	Professional		$1,071.52	$1,202.26	$1,513.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,884.03 / $3,630.78	Professional		$1,949.84	$2,884.03	$3,630.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $1,995.26 / $2,754.23	Professional		$151.36	$1,995.26	$2,754.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,819.70 / $3,467.37	Facility		$1,513.56	$1,819.70	$3,467.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,513.56 / $6,165.95	Professional		$912.01	$1,513.56	$6,165.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,949.84	Professional		$1,819.70	$1,819.70	$1,949.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,659.59 / $3,235.94	Professional		$1,513.56	$1,659.59	$3,235.94
United Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $3,467.37	Facility		$1,513.56	$1,513.56	$3,467.37
United Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $912.01 / $3,801.89	Professional		$912.01	$912.01	$3,801.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Professional		$1,513.56	$1,513.56	$1,513.56