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 $717.59 / $1,178.60 / $1,242.34	Professional		$717.59	$1,178.60	$1,242.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,470.00 / $1,784.14 / $2,230.17	Professional		$1,470.00	$1,784.14	$2,230.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $731.86 / $1,167.21 / $2,679.66	Professional		$731.86	$1,167.21	$2,679.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,074.85 / $1,939.05 / $12,342.67	Facility		$1,074.85	$1,939.05	$12,342.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $818.47 / $1,559.59 / $5,848.40	Professional		$818.47	$1,559.59	$5,848.40
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,470.00 / $2,091.28 / $9,128.52	Facility		$1,470.00	$2,091.28	$9,128.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,132.00 / $1,759.82 / $2,328.64	Professional		$1,132.00	$1,759.82	$2,328.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,400.82 / $1,400.82 / $1,400.82	Professional		$1,400.82	$1,400.82	$1,400.82
United Facility/Professional Facility Modifier Low / Median / High Price $7,221.00 / $8,060.00 / $11,869.99	Facility		$7,221.00	$8,060.00	$11,869.99
United Facility/Professional Professional Modifier Low / Median / High Price $781.26 / $1,190.50 / $2,217.30	Professional		$781.26	$1,190.50	$2,217.30
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,225.92 / $1,551.80 / $1,825.60	Professional		$1,225.92	$1,551.80	$1,825.60