Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $831.87 / $3,714.90 / $6,408.55	Facility		$831.87	$3,714.90	$6,408.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $337.98 / $437.83 / $1,425.00	Professional		$337.98	$437.83	$1,425.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $654.29 / $740.86 / $832.66	Professional		$654.29	$740.86	$832.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $278.73 / $490.87 / $968.83	Professional		$278.73	$490.87	$968.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $474.96 / $801.89 / $8,586.74	Facility		$474.96	$801.89	$8,586.74
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $7,119.48 / $7,119.48 / $7,119.48	Facility	52	$7,119.48	$7,119.48	$7,119.48
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $1,779.87 / $1,779.87 / $1,779.87	Facility	53	$1,779.87	$1,779.87	$1,779.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $391.53 / $710.15 / $2,853.12	Professional		$391.53	$710.15	$2,853.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $549.00 / $913.52 / $3,170.91	Facility		$549.00	$913.52	$3,170.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $472.73 / $654.29 / $913.52	Professional		$472.73	$654.29	$913.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $530.50 / $738.00	Professional		$3.00	$530.50	$738.00
United Facility/Professional Facility Modifier Low / Median / High Price $4,217.00 / $5,732.00 / $8,342.00	Facility		$4,217.00	$5,732.00	$8,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $351.90 / $604.10 / $954.62	Professional		$351.90	$604.10	$954.62
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $576.90 / $576.90 / $678.70	Professional		$576.90	$576.90	$678.70