Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $786.06 / $4,014.00 / $6,345.10	Facility		$786.06	$4,014.00	$6,345.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,728.09 / $4,728.09 / $8,948.29	Facility	50	$4,728.09	$4,728.09	$8,948.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.00 / $1,250.00 / $3,294.42	Professional		$339.00	$1,250.00	$3,294.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $5,094.43 / $5,094.43 / $5,094.43	Professional	50	$5,094.43	$5,094.43	$5,094.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $576.53 / $730.68 / $2,999.95	Professional		$576.53	$730.68	$2,999.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $253.91 / $1,402.85 / $4,988.62	Professional		$253.91	$1,402.85	$4,988.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $656.19 / $3,015.23 / $8,545.00	Facility		$656.19	$3,015.23	$8,545.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $730.20 / $3,035.43 / $9,157.00	Professional		$730.20	$3,035.43	$9,157.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $632.26 / $2,569.33 / $3,465.00	Facility		$632.26	$2,569.33	$3,465.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $593.89 / $2,268.52 / $3,478.01	Professional		$593.89	$2,268.52	$3,478.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $282.62 / $961.15 / $3,215.07	Professional		$282.62	$961.15	$3,215.07
United Facility/Professional Facility Modifier Low / Median / High Price $4,700.00 / $7,805.64 / $10,320.00	Facility		$4,700.00	$7,805.64	$10,320.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,528.13 / $3,035.43 / $4,389.68	Professional		$1,528.13	$3,035.43	$4,389.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $544.50 / $640.60 / $2,402.10	Professional		$544.50	$640.60	$2,402.10