Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,051.63 / $3,666.78 / $6,446.00	Facility		$1,051.63	$3,666.78	$6,446.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.36 / $498.98 / $1,051.63	Professional		$318.36	$498.98	$1,051.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $332.92 / $730.80 / $913.49	Professional		$332.92	$730.80	$913.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $319.62 / $475.59 / $1,819.03	Professional		$319.62	$475.59	$1,819.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $472.50 / $852.37 / $6,267.00	Facility		$472.50	$852.37	$6,267.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $6,012.68 / $6,012.68 / $6,012.68	Facility	52	$6,012.68	$6,012.68	$6,012.68
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $1,503.17 / $1,503.17 / $1,503.17	Facility	53	$1,503.17	$1,503.17	$1,503.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $371.68 / $711.13 / $2,445.36	Professional		$371.68	$711.13	$2,445.36
Midlands Facility/Professional Facility Modifier Low / Median / High Price $609.60 / $1,022.64 / $2,630.67	Facility		$609.60	$1,022.64	$2,630.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $521.82 / $784.09 / $1,012.60	Professional		$521.82	$784.09	$1,012.60
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,898.56 / $2,898.56 / $2,898.56	Facility		$2,898.56	$2,898.56	$2,898.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $296.23 / $553.94 / $2,880.78	Professional		$296.23	$553.94	$2,880.78
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 $346.10 / $586.70 / $1,052.10	Professional		$346.10	$586.70	$1,052.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $496.83 / $628.90 / $739.90	Professional		$496.83	$628.90	$739.90