Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,888.87 / $6,446.00 / $11,611.47	Facility		$2,888.87	$6,446.00	$11,611.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $907.79 / $1,520.46 / $4,835.00	Professional		$907.79	$1,520.46	$4,835.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,144.90 / $2,539.12 / $2,909.94	Professional		$2,144.90	$2,539.12	$2,909.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $923.31 / $1,511.25 / $3,146.34	Professional		$923.31	$1,511.25	$3,146.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,520.46 / $2,709.85 / $14,396.24	Facility		$1,520.46	$2,709.85	$14,396.24
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $12,547.52 / $12,547.52 / $12,547.52	Facility	52	$12,547.52	$12,547.52	$12,547.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,135.54 / $2,289.46 / $7,671.04	Professional		$1,135.54	$2,289.46	$7,671.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,613.00 / $2,938.21 / $5,383.60	Facility		$1,613.00	$2,938.21	$5,383.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,474.91 / $2,237.23 / $2,938.21	Professional		$1,474.91	$2,237.23	$2,938.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $1,810.20 / $2,708.10	Professional		$5.00	$1,810.20	$2,708.10
United Facility/Professional Facility Modifier Low / Median / High Price $6,354.00 / $9,755.45 / $11,869.99	Facility		$6,354.00	$9,755.45	$11,869.99
United Facility/Professional Professional Modifier Low / Median / High Price $1,083.51 / $1,948.88 / $3,079.71	Professional		$1,083.51	$1,948.88	$3,079.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,894.40 / $1,894.40 / $2,228.69	Professional		$1,894.40	$1,894.40	$2,228.69