Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $3,388.44 / $6,456.54	Facility		$776.25	$3,388.44	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $776.25 / $2,398.83	Professional		$489.78	$776.25	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,445.44 / $2,089.30	Professional		$933.25	$1,445.44	$2,089.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $851.14 / $1,819.70	Professional		$489.78	$851.14	$1,819.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,513.56 / $8,128.31	Facility		$776.25	$1,513.56	$8,128.31
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	AS	$223.87	$223.87	$223.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,412.54 / $4,168.69	Professional		$758.58	$1,412.54	$4,168.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,288.25 / $1,862.09	Professional		$1,148.15	$1,288.25	$1,862.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,513.56 / $1,862.09	Professional		$1,148.15	$1,513.56	$1,862.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $851.14 / $1,445.44	Professional		$467.74	$851.14	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $4,786.30 / $7,585.78 / $10,232.93	Facility		$4,786.30	$7,585.78	$10,232.93
United Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $912.01 / $1,737.80	Professional		$537.03	$912.01	$1,737.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,122.02 / $1,584.89	Professional		$954.99	$1,122.02	$1,584.89