Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $5,370.32 / $7,943.28	Facility		$1,000.00	$5,370.32	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $660.69 / $1,513.56	Professional		$524.81	$660.69	$1,513.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,380.38 / $1,698.24	Professional		$602.56	$1,380.38	$1,698.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $1,023.29 / $2,884.03	Professional		$562.34	$1,023.29	$2,884.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,122.02 / $3,388.44	Facility		$616.60	$1,122.02	$3,388.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,122.02 / $4,570.88	Professional		$630.96	$1,122.02	$4,570.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,348.96 / $1,659.59	Professional		$1,122.02	$1,348.96	$1,659.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,122.02 / $1,659.59	Professional		$1,000.00	$1,122.02	$1,659.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,096.48 / $1,479.11	Professional		$616.60	$1,096.48	$1,479.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $4,897.79 / $7,413.10	Facility		$1,318.26	$4,897.79	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $870.96 / $1,659.59	Professional		$602.56	$870.96	$1,659.59
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,202.26 / $1,412.54	Professional		$933.25	$1,202.26	$1,412.54