Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,455.09 / $3,167.00 / $5,934.16	Facility		$1,455.09	$3,167.00	$5,934.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.45 / $765.84 / $2,976.00	Professional		$176.45	$765.84	$2,976.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $350.80 / $1,059.68 / $1,421.86	Professional		$350.80	$1,059.68	$1,421.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.21 / $577.05 / $1,117.58	Professional		$150.21	$577.05	$1,117.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $382.37 / $1,179.39 / $4,645.00	Facility		$382.37	$1,179.39	$4,645.00
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $145.93 / $145.93 / $145.93	Facility	53	$145.93	$145.93	$145.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $432.36 / $1,308.56 / $2,368.33	Professional		$432.36	$1,308.56	$2,368.33
Midlands Facility/Professional Facility Modifier Low / Median / High Price $393.87 / $1,140.33 / $1,482.77	Facility		$393.87	$1,140.33	$1,482.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $350.80 / $1,059.68 / $1,536.38	Professional		$350.80	$1,059.68	$1,536.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $154.27 / $461.40 / $1,459.54	Professional		$154.27	$461.40	$1,459.54
United Facility/Professional Facility Modifier Low / Median / High Price $3,044.00 / $5,023.00 / $7,305.00	Facility		$3,044.00	$5,023.00	$7,305.00
United Facility/Professional Professional Modifier Low / Median / High Price $687.67 / $1,268.32 / $1,865.48	Professional		$687.67	$1,268.32	$1,865.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $285.80 / $336.20 / $1,015.60	Professional		$285.80	$336.20	$1,015.60