Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $4,570.88 / $8,511.38	Facility		$851.14	$4,570.88	$8,511.38
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Facility	50	$3,890.45	$3,890.45	$3,890.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $851.14 / $2,511.89	Professional		$478.63	$851.14	$2,511.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Facility		$4,168.69	$4,168.69	$4,168.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $1,174.90 / $1,479.11	Professional		$501.19	$1,174.90	$1,479.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $891.25 / $1,621.81	Professional		$489.78	$891.25	$1,621.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $1,148.15 / $9,120.11	Facility		$562.34	$1,148.15	$9,120.11
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility	50	$3,630.78	$3,630.78	$3,630.78
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $912.01 / $912.01 / $912.01	Facility	AS	$912.01	$912.01	$912.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $954.99 / $4,073.80	Professional		$537.03	$954.99	$4,073.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,174.90 / $1,412.54	Professional		$891.25	$1,174.90	$1,412.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Facility		$4,168.69	$4,168.69	$4,168.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,023.29 / $1,412.54	Professional		$831.76	$1,023.29	$1,412.54
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility		$3,630.78	$3,630.78	$3,630.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $954.99 / $1,258.93	Professional		$537.03	$954.99	$1,258.93
United Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $7,762.47 / $10,964.78	Facility		$3,715.35	$7,762.47	$10,964.78
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $741.31 / $1,412.54	Professional		$512.86	$741.31	$1,412.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,023.29 / $1,202.26	Professional		$812.83	$1,023.29	$1,202.26