Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,250.48 / $2,256.67 / $3,156.57	Facility		$1,250.48	$2,256.67	$3,156.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $765.60 / $1,009.20 / $1,125.20	Professional		$765.60	$1,009.20	$1,125.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,132.00 / $3,225.96 / $3,319.92	Facility		$3,132.00	$3,225.96	$3,319.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,393.15 / $2,106.59 / $2,633.23	Professional		$1,393.15	$2,106.59	$2,633.23
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,276.00 / $1,914.00 / $2,099.60	Professional		$1,276.00	$1,914.00	$2,099.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,160.00 / $1,496.90 / $2,969.60	Facility		$1,160.00	$1,496.90	$2,969.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $696.00 / $1,044.00 / $4,561.35	Professional		$696.00	$1,044.00	$4,561.35
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,392.00 / $2,121.35 / $3,319.92	Facility		$1,392.00	$2,121.35	$3,319.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,392.00 / $2,121.35 / $3,027.60	Professional		$1,392.00	$2,121.35	$3,027.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,160.00 / $1,160.00 / $2,070.60	Professional		$1,160.00	$1,160.00	$2,070.60
United Facility/Professional Facility Modifier Low / Median / High Price $1,160.00 / $1,160.00 / $2,668.00	Facility		$1,160.00	$1,160.00	$2,668.00
United Facility/Professional Professional Modifier Low / Median / High Price $696.00 / $696.00 / $2,375.10	Professional		$696.00	$696.00	$2,375.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,160.00 / $1,160.00 / $1,160.00	Professional		$1,160.00	$1,160.00	$1,160.00