Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,496.00 / $4,964.00 / $7,119.04	Facility		$3,496.00	$4,964.00	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.72 / $539.57 / $780.38	Professional		$311.72	$539.57	$780.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $748.17 / $836.17 / $1,213.39	Professional		$748.17	$836.17	$1,213.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $321.02 / $504.45 / $1,743.86	Professional		$321.02	$504.45	$1,743.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $539.57 / $1,110.34 / $6,608.00	Facility		$539.57	$1,110.34	$6,608.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $382.78 / $805.50 / $3,327.23	Professional		$382.78	$805.50	$3,327.23
Midlands Facility/Professional Facility Modifier Low / Median / High Price $748.17 / $1,065.79 / $2,256.42	Facility		$748.17	$1,065.79	$2,256.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $594.63 / $836.17 / $1,213.39	Professional		$594.63	$836.17	$1,213.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $333.02 / $598.89 / $2,476.73	Professional		$333.02	$598.89	$2,476.73
United Facility/Professional Facility Modifier Low / Median / High Price $4,217.00 / $5,327.00 / $8,342.00	Facility		$4,217.00	$5,327.00	$8,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $358.26 / $724.32 / $1,083.53	Professional		$358.26	$724.32	$1,083.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $521.16 / $659.70 / $776.10	Professional		$521.16	$659.70	$776.10