Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $5,011.87 / $7,943.28	Facility		$891.25	$5,011.87	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,047.13 / $2,454.71	Professional		$870.96	$1,047.13	$2,454.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $7,244.36 / $7,244.36	Facility		$7,244.36	$7,244.36	$7,244.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $2,290.87 / $2,884.03	Professional		$891.25	$2,290.87	$2,884.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,659.59 / $4,570.88	Professional		$891.25	$1,659.59	$4,570.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $2,089.30 / $13,182.57	Facility		$1,023.29	$2,089.30	$13,182.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,737.80 / $7,413.10	Professional		$1,023.29	$1,737.80	$7,413.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,238.72 / $2,630.27	Professional		$1,905.46	$2,238.72	$2,630.27
Midlands Facility/Professional Facility Modifier Low / Median / High Price $7,244.36 / $7,244.36 / $7,244.36	Facility		$7,244.36	$7,244.36	$7,244.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,737.80 / $2,691.53	Professional		$1,258.93	$1,737.80	$2,691.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $1,905.46 / $2,570.40	Professional		$6.03	$1,905.46	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $9,120.11 / $15,488.17	Facility		$4,168.69	$9,120.11	$15,488.17
United Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,380.38 / $2,691.53	Professional		$977.24	$1,380.38	$2,691.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,905.46 / $2,238.72	Professional		$1,513.56	$1,905.46	$2,238.72