Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,650.00 / $5,155.32 / $7,211.13	Facility		$2,650.00	$5,155.32	$7,211.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,749.00 / $2,040.50 / $2,570.50	Professional		$1,749.00	$2,040.50	$2,570.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,180.00 / $3,180.00 / $3,180.00	Facility		$3,180.00	$3,180.00	$3,180.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,445.00 / $4,813.09 / $6,016.37	Professional		$3,445.00	$4,813.09	$6,016.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,252.50 / $3,577.50 / $4,796.50	Professional		$2,252.50	$3,577.50	$4,796.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,650.00 / $3,180.00 / $7,288.67	Facility		$2,650.00	$3,180.00	$7,288.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,590.00 / $1,590.00 / $10,637.63	Professional		$1,590.00	$1,590.00	$10,637.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $3,180.00 / $3,445.00 / $7,288.67	Facility		$3,180.00	$3,445.00	$7,288.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $3,180.00 / $3,445.00 / $7,288.67	Professional		$3,180.00	$3,445.00	$7,288.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,650.00 / $2,650.00 / $4,730.25	Professional		$2,650.00	$2,650.00	$4,730.25
United Facility/Professional Professional Modifier Low / Median / High Price $1,590.00 / $1,590.00 / $5,777.00	Professional		$1,590.00	$1,590.00	$5,777.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,650.00 / $2,650.00 / $2,650.00	Professional		$2,650.00	$2,650.00	$2,650.00