Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $909.42 / $909.42 / $909.42	Facility		$909.42	$909.42	$909.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $686.83 / $1,134.93 / $4,353.83	Professional		$686.83	$1,134.93	$4,353.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,210.52 / $2,276.84 / $2,343.15	Facility		$2,210.52	$2,276.84	$2,343.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.29 / $1,857.03 / $2,321.28	Professional		$1,548.29	$1,857.03	$2,321.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $713.89 / $1,010.84 / $1,945.31	Professional		$713.89	$1,010.84	$1,945.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $909.42 / $1,556.16 / $1,990.40	Facility		$909.42	$1,556.16	$1,990.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $779.79 / $1,083.08 / $2,676.94	Professional		$779.79	$1,083.08	$2,676.94
Midlands Facility/Professional Facility Modifier Low / Median / High Price $566.07 / $1,548.29 / $2,343.15	Facility		$566.07	$1,548.29	$2,343.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,058.00 / $1,550.16 / $2,077.71	Professional		$1,058.00	$1,550.16	$2,077.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $339.39 / $671.31 / $1,334.89	Professional		$339.39	$671.31	$1,334.89
United Facility/Professional Professional Modifier Low / Median / High Price $779.23 / $940.27 / $1,410.64	Professional		$779.23	$940.27	$1,410.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,165.01 / $1,474.70 / $1,734.90	Professional		$1,165.01	$1,474.70	$1,734.90