Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,393.00 / $5,549.00 / $10,506.16	Facility		$4,393.00	$5,549.00	$10,506.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,733.97 / $3,052.71 / $3,052.71	Professional		$1,733.97	$3,052.71	$3,052.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,074.21 / $4,610.81 / $5,239.45	Professional		$4,074.21	$4,610.81	$5,239.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,702.65 / $2,938.15 / $4,948.93	Professional		$1,702.65	$2,938.15	$4,948.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,372.57 / $4,869.34 / $13,960.05	Facility		$2,372.57	$4,869.34	$13,960.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,238.92 / $4,293.52 / $14,283.70	Professional		$2,238.92	$4,293.52	$14,283.70
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,861.15 / $4,172.80 / $5,599.25	Facility		$2,861.15	$4,172.80	$5,599.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,882.00 / $4,074.21 / $5,599.25	Professional		$2,882.00	$4,074.21	$5,599.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $3,433.30 / $4,800.10	Professional		$5.00	$3,433.30	$4,800.10
United Facility/Professional Facility Modifier Low / Median / High Price $7,379.00 / $10,950.43 / $15,192.34	Facility		$7,379.00	$10,950.43	$15,192.34
United Facility/Professional Professional Modifier Low / Median / High Price $2,040.31 / $3,654.81 / $5,775.49	Professional		$2,040.31	$3,654.81	$5,775.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $3,529.20 / $3,529.20 / $4,152.00	Professional		$3,529.20	$3,529.20	$4,152.00