Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,906.00 / $4,235.59 / $7,119.04	Facility		$2,906.00	$4,235.59	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $734.38 / $1,216.39 / $1,349.36	Professional		$734.38	$1,216.39	$1,349.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,456.82 / $1,872.18 / $2,340.21	Professional		$1,456.82	$1,872.18	$2,340.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $756.80 / $1,163.38 / $2,803.16	Professional		$756.80	$1,163.38	$2,803.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,030.96 / $1,987.74 / $11,139.12	Facility		$1,030.96	$1,987.74	$11,139.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $840.39 / $1,583.44 / $6,088.40	Professional		$840.39	$1,583.44	$6,088.40
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,437.00 / $2,018.09 / $6,616.19	Facility		$1,437.00	$2,018.09	$6,616.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,211.79 / $1,831.86 / $2,396.25	Professional		$1,211.79	$1,831.86	$2,396.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $803.08 / $1,486.62 / $9,340.71	Professional		$803.08	$1,486.62	$9,340.71
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 $802.19 / $1,222.38 / $2,233.44	Professional		$802.19	$1,222.38	$2,233.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,276.08 / $1,615.30 / $1,900.30	Professional		$1,276.08	$1,615.30	$1,900.30