Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $3,311.31 / $4,897.79	Facility		$1,348.96	$3,311.31	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,412.54 / $1,737.80	Professional		$1,230.27	$1,412.54	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility		$2,089.30	$2,089.30	$2,089.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $4,168.69	Professional		$3,388.44	$3,388.44	$4,168.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $1,949.84 / $3,162.28	Professional		$151.36	$1,949.84	$3,162.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $2,089.30 / $4,466.84	Facility		$1,737.80	$2,089.30	$4,466.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,096.48 / $8,709.64	Professional		$1,047.13	$1,096.48	$8,709.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,290.87 / $2,290.87	Professional		$2,089.30	$2,290.87	$2,290.87
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility		$2,089.30	$2,089.30	$2,089.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,905.46 / $3,715.35	Professional		$1,737.80	$1,905.46	$3,715.35
United Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $4,073.80	Facility		$1,737.80	$1,737.80	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $4,466.84	Professional		$1,047.13	$1,047.13	$4,466.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Professional		$1,737.80	$1,737.80	$1,737.80