Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,964.00 / $6,066.00 / $7,119.04	Facility		$4,964.00	$6,066.00	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,550.91 / $3,631.17 / $13,949.40	Professional		$2,550.91	$3,631.17	$13,949.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,760.68 / $6,190.73 / $7,760.80	Professional		$2,760.68	$6,190.73	$7,760.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,687.34 / $4,296.95 / $16,150.28	Professional		$2,687.34	$4,296.95	$16,150.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $3,239.74 / $5,684.72 / $7,556.07	Facility		$3,239.74	$5,684.72	$7,556.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $3,071.99 / $5,909.99 / $20,891.91	Professional		$3,071.99	$5,909.99	$20,891.91
Midlands Facility/Professional Facility Modifier Low / Median / High Price $4,192.39 / $6,247.89 / $8,918.21	Facility		$4,192.39	$6,247.89	$8,918.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $4,192.39 / $6,105.39 / $7,985.45	Professional		$4,192.39	$6,105.39	$7,985.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $5,522.70 / $7,267.50	Professional		$15.00	$5,522.70	$7,267.50
United Facility/Professional Facility Modifier Low / Median / High Price $1,321.00 / $5,847.00 / $7,856.00	Facility		$1,321.00	$5,847.00	$7,856.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,815.99 / $4,542.56 / $8,333.54	Professional		$2,815.99	$4,542.56	$8,333.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $4,432.53 / $5,610.80 / $6,601.00	Professional		$4,432.53	$5,610.80	$6,601.00