Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,219.00 / $6,155.00 / $12,380.40	Facility		$1,219.00	$6,155.00	$12,380.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $516.53 / $820.38 / $2,500.00	Professional		$516.53	$820.38	$2,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,088.72 / $1,355.97 / $1,540.87	Professional		$1,088.72	$1,355.97	$1,540.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $534.66 / $835.47 / $1,753.75	Professional		$534.66	$835.47	$1,753.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,052.60 / $1,702.10 / $29,124.36	Facility		$1,052.60	$1,702.10	$29,124.36
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $30,081.88 / $30,081.88 / $30,081.88	Facility	52	$30,081.88	$30,081.88	$30,081.88
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $7,520.47 / $7,520.47 / $7,520.47	Facility	53	$7,520.47	$7,520.47	$7,520.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $666.98 / $1,309.55 / $2,190.52	Professional		$666.98	$1,309.55	$2,190.52
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,109.19 / $1,531.85 / $13,210.84	Facility		$1,109.19	$1,531.85	$13,210.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $858.73 / $1,203.31 / $1,540.87	Professional		$858.73	$1,203.31	$1,540.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $527.17 / $1,010.33 / $14,483.00	Professional		$527.17	$1,010.33	$14,483.00
United Facility/Professional Facility Modifier Low / Median / High Price $8,604.00 / $13,476.00 / $23,884.54	Facility		$8,604.00	$13,476.00	$23,884.54
United Facility/Professional Professional Modifier Low / Median / High Price $639.19 / $1,345.08 / $1,823.76	Professional		$639.19	$1,345.08	$1,823.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $907.16 / $1,148.30 / $1,351.00	Professional		$907.16	$1,148.30	$1,351.00