Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,164.50 / $11,556.43 / $18,543.45	Facility		$5,164.50	$11,556.43	$18,543.45
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $12,283.96 / $12,283.96 / $16,698.50	Facility	50	$12,283.96	$12,283.96	$16,698.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $579.04 / $1,718.80 / $5,659.00	Professional		$579.04	$1,718.80	$5,659.00
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $155.68 / $432.78 / $974.39	Professional	AS	$155.68	$432.78	$974.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,582.08 / $2,993.94 / $3,750.18	Professional		$2,582.08	$2,993.94	$3,750.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,201.90 / $2,071.85 / $4,500.62	Professional		$1,201.90	$2,071.85	$4,500.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,005.88 / $3,517.57 / $20,063.05	Facility		$2,005.88	$3,517.57	$20,063.05
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $34,832.28 / $34,832.28 / $34,832.28	Facility	54	$34,832.28	$34,832.28	$34,832.28
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $4,976.04 / $4,976.04 / $4,976.04	Facility	AS	$4,976.04	$4,976.04	$4,976.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,472.09 / $2,769.46 / $11,316.67	Professional		$1,472.09	$2,769.46	$11,316.67
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,829.67 / $3,750.18 / $17,645.08	Facility		$2,829.67	$3,750.18	$17,645.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,042.50 / $2,979.84 / $3,848.22	Professional		$2,042.50	$2,979.84	$3,848.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,205.85 / $2,257.21 / $19,072.88	Professional		$1,205.85	$2,257.21	$19,072.88
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 $1,344.08 / $2,074.32 / $3,917.26	Professional		$1,344.08	$2,074.32	$3,917.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,971.13 / $2,495.10 / $2,935.40	Professional		$1,971.13	$2,495.10	$2,935.40