Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,602.14 / $4,964.00 / $7,880.15	Facility		$1,602.14	$4,964.00	$7,880.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $462.25 / $669.32 / $1,356.08	Professional		$462.25	$669.32	$1,356.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $864.65 / $1,176.10 / $1,708.18	Professional		$864.65	$1,176.10	$1,708.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $445.04 / $790.01 / $1,573.33	Professional		$445.04	$790.01	$1,573.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $700.25 / $1,227.24 / $5,567.24	Facility		$700.25	$1,227.24	$5,567.24
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $203.00 / $203.00 / $203.00	Facility	AS	$203.00	$203.00	$203.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $658.40 / $1,219.22 / $4,425.84	Professional		$658.40	$1,219.22	$4,425.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $975.98 / $1,316.00 / $2,932.27	Facility		$975.98	$1,316.00	$2,932.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $897.81 / $1,188.09 / $1,579.30	Professional		$897.81	$1,188.09	$1,579.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $436.02 / $796.32 / $3,254.15	Professional		$436.02	$796.32	$3,254.15
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 $601.15 / $916.03 / $1,717.56	Professional		$601.15	$916.03	$1,717.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $860.60 / $1,012.50 / $1,342.40	Professional		$860.60	$1,012.50	$1,342.40