Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $5,888.44 / $7,943.28	Facility		$1,584.89	$5,888.44	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,230.27 / $3,090.30	Professional		$870.96	$1,230.27	$3,090.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $2,089.30 / $2,630.27	Professional		$1,174.90	$2,089.30	$2,630.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,122.02 / $2,290.87	Professional		$645.65	$1,122.02	$2,290.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $2,691.53 / $7,079.46	Facility		$1,380.38	$2,691.53	$7,079.46
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $4,570.88 / $4,570.88 / $4,570.88	Facility	54	$4,570.88	$4,570.88	$4,570.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,819.70 / $6,760.83	Professional		$1,047.13	$1,819.70	$6,760.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,089.30 / $2,398.83	Professional		$1,513.56	$2,089.30	$2,398.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Professional		$1,819.70	$1,819.70	$1,819.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,348.96 / $1,737.80	Professional		$758.58	$1,348.96	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $5,754.40 / $7,585.78	Facility		$3,311.31	$5,754.40	$7,585.78
United Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,380.38 / $2,570.40	Professional		$933.25	$1,380.38	$2,570.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,862.09 / $1,995.26	Professional		$1,318.26	$1,862.09	$1,995.26