Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,576.00 / $4,964.00 / $10,506.16	Facility		$2,576.00	$4,964.00	$10,506.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $971.87 / $1,679.68 / $4,475.00	Professional		$971.87	$1,679.68	$4,475.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,049.00 / $2,391.84 / $2,989.80	Professional		$2,049.00	$2,391.84	$2,989.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $986.66 / $1,580.87 / $3,368.99	Professional		$986.66	$1,580.87	$3,368.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,679.68 / $2,615.75 / $14,479.00	Facility		$1,679.68	$2,615.75	$14,479.00
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $1,887.52 / $1,887.52 / $1,887.52	Facility	AS	$1,887.52	$1,887.52	$1,887.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,113.39 / $2,093.69 / $7,887.28	Professional		$1,113.39	$2,093.69	$7,887.28
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,955.76 / $2,615.75 / $6,616.19	Facility		$1,955.76	$2,615.75	$6,616.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,602.62 / $2,363.15 / $3,154.48	Professional		$1,602.62	$2,363.15	$3,154.48
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $5,577.01 / $5,577.01 / $5,577.01	Facility		$5,577.01	$5,577.01	$5,577.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,048.21 / $1,907.11 / $7,323.26	Professional		$1,048.21	$1,907.11	$7,323.26
United Facility/Professional Facility Modifier Low / Median / High Price $8,220.00 / $9,259.00 / $14,242.22	Facility		$8,220.00	$9,259.00	$14,242.22
United Facility/Professional Professional Modifier Low / Median / High Price $1,062.78 / $1,619.47 / $3,036.51	Professional		$1,062.78	$1,619.47	$3,036.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,646.20 / $2,083.80 / $2,451.50	Professional		$1,646.20	$2,083.80	$2,451.50