Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,182.89 / $3,489.13 / $6,446.00	Facility		$1,182.89	$3,489.13	$6,446.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $335.08 / $521.16 / $1,058.35	Professional		$335.08	$521.16	$1,058.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $751.05 / $982.23 / $1,337.13	Professional		$751.05	$982.23	$1,337.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $309.27 / $597.82 / $1,109.82	Professional		$309.27	$597.82	$1,109.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $531.00 / $971.83 / $4,645.00	Facility		$531.00	$971.83	$4,645.00
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $155.02 / $155.02 / $155.02	Facility	AS	$155.02	$155.02	$155.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $546.27 / $1,006.79 / $3,449.25	Professional		$546.27	$1,006.79	$3,449.25
Midlands Facility/Professional Facility Modifier Low / Median / High Price $671.35 / $1,006.79 / $1,331.66	Facility		$671.35	$1,006.79	$1,331.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $628.22 / $851.68 / $1,198.58	Professional		$628.22	$851.68	$1,198.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $543.60 / $884.60 / $1,261.20	Professional		$543.60	$884.60	$1,261.20
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 $492.95 / $883.02 / $1,395.38	Professional		$492.95	$883.02	$1,395.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $657.20 / $773.10 / $1,074.40	Professional		$657.20	$773.10	$1,074.40