Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $5,370.32 / $7,943.28	Facility		$1,000.00	$5,370.32	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $645.65 / $1,513.56	Professional		$537.03	$645.65	$1,513.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility		$1,202.26	$1,202.26	$1,202.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,380.38 / $1,737.80	Professional		$575.44	$1,380.38	$1,737.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $1,023.29 / $2,238.72	Professional		$562.34	$1,023.29	$2,238.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,288.25 / $3,388.44	Facility		$616.60	$1,288.25	$3,388.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,096.48 / $4,677.35	Professional		$616.60	$1,096.48	$4,677.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,348.96 / $1,659.59	Professional		$977.24	$1,348.96	$1,659.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility		$1,202.26	$1,202.26	$1,202.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,148.15 / $1,659.59	Professional		$870.96	$1,148.15	$1,659.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $1,174.90 / $1,584.89	Professional		$7.08	$1,174.90	$1,584.89
United Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $3,162.28 / $6,309.57	Facility		$1,412.54	$3,162.28	$6,309.57
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $851.14 / $1,584.89	Professional		$588.84	$851.14	$1,584.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,202.26 / $1,412.54	Professional		$933.25	$1,202.26	$1,412.54