Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,468.00 / $4,917.20 / $8,042.03	Facility		$3,468.00	$4,917.20	$8,042.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $516.41 / $766.65 / $2,753.39	Professional		$516.41	$766.65	$2,753.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,039.30 / $1,344.92 / $1,865.94	Professional		$1,039.30	$1,344.92	$1,865.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $431.79 / $820.93 / $1,320.80	Professional		$431.79	$820.93	$1,320.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $844.00 / $1,488.44 / $7,273.98	Facility		$844.00	$1,488.44	$7,273.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $726.00 / $1,413.33 / $4,851.43	Professional		$726.00	$1,413.33	$4,851.43
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,039.30 / $1,449.59 / $2,571.84	Facility		$1,039.30	$1,449.59	$2,571.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $826.45 / $1,213.24 / $1,708.48	Professional		$826.45	$1,213.24	$1,708.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $1,403.70 / $1,717.60	Professional		$5.00	$1,403.70	$1,717.60
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 $671.28 / $1,203.08 / $1,901.16	Professional		$671.28	$1,203.08	$1,901.16
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $900.30 / $1,059.09 / $1,446.30	Professional		$900.30	$1,059.09	$1,446.30