Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $2,238.72 / $6,025.60	Facility		$524.81	$2,238.72	$6,025.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $616.60 / $1,513.56	Professional		$257.04	$616.60	$1,513.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $707.95 / $1,819.70	Professional		$302.00	$707.95	$1,819.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $870.96 / $1,513.56	Professional		$239.88	$870.96	$1,513.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $954.99 / $2,951.21	Facility		$363.08	$954.99	$2,951.21
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $933.25 / $933.25 / $933.25	Facility	52	$933.25	$933.25	$933.25
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $229.09 / $229.09 / $229.09	Facility	53	$229.09	$229.09	$229.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,318.26 / $4,897.79	Professional		$660.69	$1,318.26	$4,897.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,174.90 / $1,862.09	Professional		$616.60	$1,174.90	$1,862.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,230.27 / $1,949.84	Professional		$645.65	$1,230.27	$1,949.84
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $977.24	Facility		$977.24	$977.24	$977.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $676.08 / $1,513.56	Professional		$239.88	$676.08	$1,513.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $3,630.78 / $6,309.57	Facility		$1,778.28	$3,630.78	$6,309.57
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $724.44 / $1,584.89	Professional		$302.00	$724.44	$1,584.89
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $602.56 / $1,479.11	Professional		$489.78	$602.56	$1,479.11