Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,632.78 / $4,522.00 / $8,588.76	Facility		$1,632.78	$4,522.00	$8,588.76
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,915.88 / $3,915.88 / $3,915.88	Facility	50	$3,915.88	$3,915.88	$3,915.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $465.97 / $803.83 / $2,191.00	Professional		$465.97	$803.83	$2,191.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,285.00 / $1,285.00 / $1,285.00	Facility		$1,285.00	$1,285.00	$1,285.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $497.41 / $1,145.28 / $1,431.60	Professional		$497.41	$1,145.28	$1,431.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $486.17 / $763.61 / $1,635.87	Professional		$486.17	$763.61	$1,635.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $730.46 / $1,248.46 / $7,915.44	Facility		$730.46	$1,248.46	$7,915.44
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $3,595.36 / $3,595.36 / $3,595.36	Facility	50	$3,595.36	$3,595.36	$3,595.36
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $905.99 / $905.99 / $905.99	Facility	AS	$905.99	$905.99	$905.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $574.39 / $1,119.32 / $4,067.23	Professional		$574.39	$1,119.32	$4,067.23
Midlands Facility/Professional Facility Modifier Low / Median / High Price $813.00 / $1,389.41 / $3,162.53	Facility		$813.00	$1,389.41	$3,162.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $744.00 / $1,160.09 / $1,526.44	Professional		$744.00	$1,160.09	$1,526.44
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,637.27 / $3,637.27 / $3,637.27	Facility		$3,637.27	$3,637.27	$3,637.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $523.08 / $978.68 / $3,472.60	Professional		$523.08	$978.68	$3,472.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,770.00 / $6,588.00 / $10,320.00	Facility		$1,770.00	$6,588.00	$10,320.00
United Facility/Professional Professional Modifier Low / Median / High Price $539.36 / $784.53 / $1,596.17	Professional		$539.36	$784.53	$1,596.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $808.09 / $1,022.90 / $1,203.50	Professional		$808.09	$1,022.90	$1,203.50