Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,277.00 / $5,463.36 / $10,506.16	Facility		$4,277.00	$5,463.36	$10,506.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $490.51 / $803.33 / $1,017.42	Professional		$490.51	$803.33	$1,017.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,036.96 / $1,270.08 / $1,459.84	Professional		$1,036.96	$1,270.08	$1,459.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $405.43 / $775.29 / $1,228.72	Professional		$405.43	$775.29	$1,228.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $769.00 / $1,316.00 / $8,342.00	Facility		$769.00	$1,316.00	$8,342.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $566.41 / $1,142.26 / $3,909.60	Professional		$566.41	$1,142.26	$3,909.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $769.00 / $1,418.64 / $3,093.19	Facility		$769.00	$1,418.64	$3,093.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $677.35 / $1,084.64 / $1,459.20	Professional		$677.35	$1,084.64	$1,459.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $862.70 / $1,386.70	Professional		$3.00	$862.70	$1,386.70
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 $541.73 / $944.64 / $1,536.53	Professional		$541.73	$944.64	$1,536.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,020.70 / $1,020.70 / $1,200.80	Professional		$1,020.70	$1,020.70	$1,200.80