Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,476.00 / $3,701.00 / $9,248.33	Facility		$2,476.00	$3,701.00	$9,248.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.08 / $1,633.37 / $5,193.39	Professional		$794.08	$1,633.37	$5,193.39
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $25.11 / $624.38 / $920.60	Professional	AS	$25.11	$624.38	$920.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,253.31 / $2,376.25 / $3,083.29	Professional		$1,253.31	$2,376.25	$3,083.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $797.39 / $1,412.60 / $1,996.51	Professional		$797.39	$1,412.60	$1,996.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,214.86 / $2,269.90 / $8,847.00	Facility		$1,214.86	$2,269.90	$8,847.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,224.22 / $2,111.84 / $6,420.24	Professional		$1,224.22	$2,111.84	$6,420.24
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,910.48 / $2,656.11 / $3,908.14	Facility		$1,910.48	$2,656.11	$3,908.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,621.44 / $2,158.16 / $2,914.80	Professional		$1,621.44	$2,158.16	$2,914.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $841.63 / $1,554.25 / $3,885.28	Professional		$841.63	$1,554.25	$3,885.28
United Facility/Professional Facility Modifier Low / Median / High Price $4,717.39 / $7,091.00 / $10,320.00	Facility		$4,717.39	$7,091.00	$10,320.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,139.08 / $1,530.27 / $2,822.84	Professional		$1,139.08	$1,530.27	$2,822.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,529.20 / $1,830.90 / $2,277.30	Professional		$1,529.20	$1,830.90	$2,277.30