Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,906.00 / $4,235.59 / $7,119.04	Facility		$2,906.00	$4,235.59	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.60 / $661.62 / $661.62	Professional		$416.60	$661.62	$661.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $978.45 / $1,123.66 / $1,280.65	Professional		$978.45	$1,123.66	$1,280.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $418.92 / $696.87 / $1,215.44	Professional		$418.92	$696.87	$1,215.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $661.62 / $1,202.19 / $9,388.90	Facility		$661.62	$1,202.19	$9,388.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $568.29 / $1,057.44 / $4,505.85	Professional		$568.29	$1,057.44	$4,505.85
Midlands Facility/Professional Facility Modifier Low / Median / High Price $772.00 / $1,379.67 / $3,170.91	Facility		$772.00	$1,379.67	$3,170.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $707.73 / $994.16 / $1,379.67	Professional		$707.73	$994.16	$1,379.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $791.30 / $1,129.20	Professional		$3.00	$791.30	$1,129.20
United Facility/Professional Facility Modifier Low / Median / High Price $4,700.00 / $7,805.64 / $10,320.00	Facility		$4,700.00	$7,805.64	$10,320.00
United Facility/Professional Professional Modifier Low / Median / High Price $502.50 / $900.14 / $1,422.44	Professional		$502.50	$900.14	$1,422.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $876.60 / $876.60 / $1,031.30	Professional		$876.60	$876.60	$1,031.30