Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $725.00 / $1,410.42 / $1,972.86	Facility		$725.00	$1,410.42	$1,972.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.75 / $630.75 / $703.25	Professional		$630.75	$630.75	$703.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.72 / $1,316.70 / $1,645.87	Professional		$870.72	$1,316.70	$1,645.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $616.25 / $978.75 / $1,312.25	Professional		$616.25	$978.75	$1,312.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $725.00 / $935.56 / $1,856.00	Facility		$725.00	$935.56	$1,856.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $435.00 / $449.50 / $2,339.65	Professional		$435.00	$449.50	$2,339.65
Midlands Facility/Professional Facility Modifier Low / Median / High Price $870.00 / $1,015.00 / $1,493.50	Facility		$870.00	$1,015.00	$1,493.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $870.00 / $1,102.00 / $1,493.50	Professional		$870.00	$1,102.00	$1,493.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $725.00 / $725.00 / $1,294.11	Professional		$725.00	$725.00	$1,294.11
United Facility/Professional Professional Modifier Low / Median / High Price $435.00 / $435.00 / $1,484.44	Professional		$435.00	$435.00	$1,484.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $725.00 / $725.00 / $725.00	Professional		$725.00	$725.00	$725.00