Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,054.01 / $7,119.04 / $12,232.50	Facility		$2,054.01	$7,119.04	$12,232.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.87 / $1,122.74 / $3,033.00	Professional		$630.87	$1,122.74	$3,033.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $651.67 / $1,433.54 / $1,950.68	Professional		$651.67	$1,433.54	$1,950.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $613.77 / $1,076.92 / $2,022.95	Professional		$613.77	$1,076.92	$2,022.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $996.80 / $1,624.75 / $11,716.00	Facility		$996.80	$1,624.75	$11,716.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $12,302.24 / $12,302.24 / $12,302.24	Facility	52	$12,302.24	$12,302.24	$12,302.24
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $3,075.56 / $3,075.56 / $3,075.56	Facility	53	$3,075.56	$3,075.56	$3,075.56
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $1,537.78 / $1,537.78 / $1,537.78	Facility	AS	$1,537.78	$1,537.78	$1,537.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $743.65 / $1,431.14 / $4,971.47	Professional		$743.65	$1,431.14	$4,971.47
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,160.00 / $1,753.79 / $5,275.65	Facility		$1,160.00	$1,753.79	$5,275.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $979.73 / $1,459.96 / $1,929.36	Professional		$979.73	$1,459.96	$1,929.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $664.60 / $1,237.33 / $6,001.62	Professional		$664.60	$1,237.33	$6,001.62
United Facility/Professional Facility Modifier Low / Median / High Price $1,770.00 / $9,082.00 / $13,476.00	Facility		$1,770.00	$9,082.00	$13,476.00
United Facility/Professional Professional Modifier Low / Median / High Price $681.68 / $992.45 / $2,017.34	Professional		$681.68	$992.45	$2,017.34
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,017.05 / $1,287.40 / $1,514.50	Professional		$1,017.05	$1,287.40	$1,514.50