Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,454.71 / $3,548.13	Facility		$1,000.00	$2,454.71	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,096.48 / $1,621.81	Professional		$891.25	$1,096.48	$1,621.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,454.71 / $3,090.30	Professional		$1,548.82	$2,454.71	$3,090.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,862.09 / $2,238.72	Professional		$1,096.48	$1,862.09	$2,238.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,548.82 / $3,311.31	Facility		$1,230.27	$1,548.82	$3,311.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,288.25 / $5,011.87	Professional		$776.25	$1,288.25	$5,011.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,659.59	Professional		$1,548.82	$1,548.82	$1,659.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,380.38 / $2,754.23	Professional		$1,288.25	$1,380.38	$2,754.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $2,818.38	Facility		$1,288.25	$1,288.25	$2,818.38
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $2,951.21	Professional		$776.25	$776.25	$2,951.21
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Professional		$1,288.25	$1,288.25	$1,288.25