Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,458.60 / $4,936.02 / $8,647.71	Facility		$2,458.60	$4,936.02	$8,647.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.77 / $1,230.91 / $4,800.70	Professional		$339.77	$1,230.91	$4,800.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $723.00 / $946.86 / $2,698.61	Professional		$723.00	$946.86	$2,698.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $303.25 / $1,276.70 / $3,075.89	Professional		$303.25	$1,276.70	$3,075.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $796.52 / $2,554.19 / $8,400.95	Facility		$796.52	$2,554.19	$8,400.95
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $297.92 / $297.92 / $297.92	Facility	53	$297.92	$297.92	$297.92
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $148.96 / $148.96 / $148.96	Facility	AS	$148.96	$148.96	$148.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $773.30 / $2,328.28 / $5,494.00	Professional		$773.30	$2,328.28	$5,494.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $773.30 / $2,391.42 / $3,149.58	Facility		$773.30	$2,391.42	$3,149.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $704.88 / $2,024.73 / $2,905.16	Professional		$704.88	$2,024.73	$2,905.16
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,049.74 / $7,413.84 / $12,805.72	Facility		$3,049.74	$7,413.84	$12,805.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $327.90 / $880.40 / $3,215.07	Professional		$327.90	$880.40	$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 $1,206.23 / $2,328.28 / $3,272.20	Professional		$1,206.23	$2,328.28	$3,272.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $656.60 / $772.40 / $2,183.90	Professional		$656.60	$772.40	$2,183.90