Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,681.98 / $5,463.36 / $17,725.12	Facility		$2,681.98	$5,463.36	$17,725.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,308.09 / $1,890.83 / $3,596.47	Professional		$1,308.09	$1,890.83	$3,596.47
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $181.06 / $650.62 / $1,260.00	Professional	AS	$181.06	$650.62	$1,260.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,815.00 / $3,217.08 / $4,005.55	Professional		$2,815.00	$3,217.08	$4,005.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,354.51 / $2,184.26 / $4,122.28	Professional		$1,354.51	$2,184.26	$4,122.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,263.27 / $3,776.18 / $27,284.87	Facility		$2,263.27	$3,776.18	$27,284.87
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $7,806.31 / $7,806.31 / $7,806.31	Facility	AS	$7,806.31	$7,806.31	$7,806.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,527.65 / $2,875.38 / $10,613.28	Professional		$1,527.65	$2,875.38	$10,613.28
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,815.00 / $3,829.81 / $27,284.87	Facility		$2,815.00	$3,829.81	$27,284.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,195.42 / $3,183.39 / $4,312.92	Professional		$2,195.42	$3,183.39	$4,312.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,413.25 / $2,551.62 / $29,135.11	Professional		$1,413.25	$2,551.62	$29,135.11
United Facility/Professional Facility Modifier Low / Median / High Price $9,542.00 / $12,871.00 / $16,293.00	Facility		$9,542.00	$12,871.00	$16,293.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,500.61 / $2,199.48 / $4,282.14	Professional		$1,500.61	$2,199.48	$4,282.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,217.53 / $2,807.00 / $3,302.40	Professional		$2,217.53	$2,807.00	$3,302.40