Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,783.20 / $4,530.89 / $7,119.04	Facility		$2,783.20	$4,530.89	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.05 / $516.91 / $1,424.54	Professional		$169.05	$516.91	$1,424.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $953.00 / $953.00 / $953.00	Facility		$953.00	$953.00	$953.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.77 / $482.07 / $1,444.91	Professional		$220.77	$482.07	$1,444.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $164.30 / $536.41 / $991.09	Professional		$164.30	$536.41	$991.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $287.01 / $786.85 / $3,044.00	Facility		$287.01	$786.85	$3,044.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $634.61 / $634.61 / $634.61	Facility	52	$634.61	$634.61	$634.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $297.00 / $1,085.27 / $4,363.52	Professional		$297.00	$1,085.27	$4,363.52
Midlands Facility/Professional Facility Modifier Low / Median / High Price $334.84 / $1,205.17 / $1,633.10	Facility		$334.84	$1,205.17	$1,633.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $332.52 / $608.05 / $1,584.98	Professional		$332.52	$608.05	$1,584.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $524.48 / $1,733.96	Professional		$170.48	$524.48	$1,733.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,770.00 / $4,663.00 / $7,305.00	Facility		$1,770.00	$4,663.00	$7,305.00
United Facility/Professional Professional Modifier Low / Median / High Price $260.38 / $829.17 / $1,598.86	Professional		$260.38	$829.17	$1,598.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $336.30 / $411.40 / $1,301.59	Professional		$336.30	$411.40	$1,301.59