Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $2,570.40 / $6,760.83	Facility		$1,174.90	$2,570.40	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $794.33 / $2,570.40	Professional		$676.08	$794.33	$2,570.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,659.59 / $2,089.30	Professional		$1,288.25	$1,659.59	$2,089.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,047.13 / $3,235.94	Professional		$724.44	$1,047.13	$3,235.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,621.81 / $2,137.96	Facility		$891.25	$1,621.81	$2,137.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,412.54 / $2,691.53	Professional		$724.44	$1,412.54	$2,691.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,659.59 / $1,995.26	Professional		$1,288.25	$1,659.59	$1,995.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $2,754.23	Professional		$1,995.26	$1,995.26	$2,754.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,230.27 / $1,621.81	Professional		$691.83	$1,230.27	$1,621.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,621.81 / $3,548.13	Facility		$1,148.15	$1,621.81	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,071.52 / $1,995.26	Professional		$707.95	$1,071.52	$1,995.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,445.44 / $1,698.24	Professional		$1,148.15	$1,445.44	$1,698.24