Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,277.00 / $6,066.00 / $12,765.09	Facility		$4,277.00	$6,066.00	$12,765.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,629.60 / $2,590.30 / $2,590.30	Professional		$1,629.60	$2,590.30	$2,590.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,990.55 / $4,579.42 / $5,203.89	Professional		$3,990.55	$4,579.42	$5,203.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,788.92 / $2,974.95 / $4,745.70	Professional		$1,788.92	$2,974.95	$4,745.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,950.00 / $4,377.60 / $6,608.00	Facility		$2,950.00	$4,377.60	$6,608.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,108.98 / $4,232.50 / $13,585.92	Professional		$2,108.98	$4,232.50	$13,585.92
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,765.65 / $4,116.00 / $5,383.45	Facility		$2,765.65	$4,116.00	$5,383.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,765.65 / $4,116.00 / $5,383.45	Professional		$2,765.65	$4,116.00	$5,383.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.00 / $3,412.20 / $4,804.10	Professional		$11.00	$3,412.20	$4,804.10
United Facility/Professional Facility Modifier Low / Median / High Price $2,126.00 / $5,847.00 / $7,305.00	Facility		$2,126.00	$5,847.00	$7,305.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,043.64 / $3,641.05 / $5,633.23	Professional		$2,043.64	$3,641.05	$5,633.23
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $3,767.70 / $3,767.70 / $4,432.60	Professional		$3,767.70	$3,767.70	$4,432.60