Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,012.00 / $9,700.79 / $16,296.00	Facility		$5,012.00	$9,700.79	$16,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $592.25 / $2,007.71 / $4,028.72	Professional		$592.25	$2,007.71	$4,028.72
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $145.91 / $461.16 / $913.50	Professional	AS	$145.91	$461.16	$913.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,585.62 / $2,995.48 / $3,644.97	Professional		$2,585.62	$2,995.48	$3,644.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,203.30 / $2,074.26 / $4,038.66	Professional		$1,203.30	$2,074.26	$4,038.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,007.71 / $3,448.05 / $20,063.05	Facility		$2,007.71	$3,448.05	$20,063.05
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $35,560.28 / $35,560.28 / $35,560.28	Facility	54	$35,560.28	$35,560.28	$35,560.28
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $31,750.25 / $31,750.25 / $31,750.25	Facility	62	$31,750.25	$31,750.25	$31,750.25
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $5,080.04 / $5,080.04 / $5,080.04	Facility	AS	$5,080.04	$5,080.04	$5,080.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,446.44 / $2,751.58 / $13,550.61	Professional		$1,446.44	$2,751.58	$13,550.61
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,676.00 / $3,644.97 / $18,014.20	Facility		$2,676.00	$3,644.97	$18,014.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,043.23 / $2,833.31 / $3,851.59	Professional		$2,043.23	$2,833.31	$3,851.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,264.76 / $2,287.30 / $19,471.49	Professional		$1,264.76	$2,287.30	$19,471.49
United Facility/Professional Facility Modifier Low / Median / High Price $10,352.00 / $13,970.00 / $16,616.96	Facility		$10,352.00	$13,970.00	$16,616.96
United Facility/Professional Professional Modifier Low / Median / High Price $1,345.44 / $2,050.19 / $4,110.25	Professional		$1,345.44	$2,050.19	$4,110.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,973.66 / $2,498.30 / $2,939.20	Professional		$1,973.66	$2,498.30	$2,939.20