Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,467.75 / $5,336.04 / $10,506.16	Facility		$3,467.75	$5,336.04	$10,506.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $690.67 / $1,166.85 / $4,282.00	Professional		$690.67	$1,166.85	$4,282.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $518.00 / $972.43 / $973.41	Professional	54	$518.00	$972.43	$973.41
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $103.60 / $194.68 / $194.68	Professional	55	$103.60	$194.68	$194.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,134.51 / $1,700.00 / $2,125.00	Professional		$1,134.51	$1,700.00	$2,125.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $668.35 / $942.89 / $2,476.02	Professional		$668.35	$942.89	$2,476.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,296.58 / $2,200.39 / $6,854.80	Facility		$1,296.58	$2,200.39	$6,854.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $858.12 / $1,607.69 / $3,608.48	Professional		$858.12	$1,607.69	$3,608.48
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,598.00 / $1,953.11 / $2,428.62	Facility		$1,598.00	$1,953.11	$2,428.62
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,223.70 / $1,760.11 / $2,248.35	Professional		$1,223.70	$1,760.11	$2,248.35
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,235.26 / $1,235.26 / $1,235.26	Facility		$1,235.26	$1,235.26	$1,235.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $660.62 / $1,236.68 / $2,502.31	Professional		$660.62	$1,236.68	$2,502.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,405.00 / $5,321.00 / $8,342.00	Facility		$1,405.00	$5,321.00	$8,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $786.61 / $1,190.34 / $2,327.87	Professional		$786.61	$1,190.34	$2,327.87
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,100.23 / $1,523.70 / $1,638.40	Professional		$1,100.23	$1,523.70	$1,638.40