Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,995.26 / $2,884.03	Facility		$812.83	$1,995.26	$2,884.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $891.25 / $1,318.26	Professional		$724.44	$891.25	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,995.26 / $2,511.89	Professional		$1,258.93	$1,995.26	$2,511.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,096.48 / $1,819.70	Professional		$758.58	$1,096.48	$1,819.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,258.93 / $2,691.53	Facility		$1,000.00	$1,258.93	$2,691.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,258.93 / $3,981.07	Professional		$630.96	$1,258.93	$3,981.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,348.96	Professional		$1,258.93	$1,258.93	$1,348.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,148.15 / $2,238.72	Professional		$1,047.13	$1,148.15	$2,238.72
United Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $2,344.23	Facility		$1,047.13	$1,047.13	$2,344.23
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $2,398.83	Professional		$630.96	$630.96	$2,398.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13