Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $5,370.32 / $7,943.28	Facility		$1,412.54	$5,370.32	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $954.99 / $1,995.26	Professional		$794.33	$954.99	$1,995.26
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 $776.25 / $1,995.26 / $2,454.71	Professional		$776.25	$1,995.26	$2,454.71
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,548.82 / $3,162.28	Professional		$776.25	$1,548.82	$3,162.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,862.09 / $13,182.57	Facility		$870.96	$1,862.09	$13,182.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,621.81 / $9,120.11	Professional		$891.25	$1,621.81	$9,120.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,089.30 / $2,290.87	Professional		$1,778.28	$2,089.30	$2,290.87
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 / $1,698.24 / $2,290.87	Professional		$1,258.93	$1,698.24	$2,290.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $1,737.80 / $2,187.76	Professional		$6.03	$1,737.80	$2,187.76
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 $851.14 / $1,258.93 / $2,290.87	Professional		$851.14	$1,258.93	$2,290.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,621.81 / $1,905.46	Professional		$1,288.25	$1,621.81	$1,905.46