Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $3,981.07 / $6,760.83	Facility		$2,041.74	$3,981.07	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,698.24 / $3,715.35	Professional		$1,288.25	$1,698.24	$3,715.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $3,311.31 / $4,073.80	Professional		$2,511.89	$3,311.31	$4,073.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,041.74 / $4,168.69	Professional		$1,258.93	$2,041.74	$4,168.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $3,235.94 / $7,413.10	Facility		$1,698.24	$3,235.94	$7,413.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,570.40 / $10,715.19	Professional		$1,412.54	$2,570.40	$10,715.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $3,235.94 / $4,168.69	Professional		$2,754.23	$3,235.94	$4,168.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $4,168.69	Professional		$2,511.89	$2,511.89	$4,168.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,754.23 / $3,890.45	Professional		$1,621.81	$2,754.23	$3,890.45
United Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $6,309.57 / $9,772.37	Facility		$3,715.35	$6,309.57	$9,772.37
United Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,041.74 / $3,981.07	Professional		$1,380.38	$2,041.74	$3,981.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $3,019.95 / $3,548.13	Professional		$2,344.23	$3,019.95	$3,548.13