Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $5,011.87 / $11,481.54	Facility		$954.99	$5,011.87	$11,481.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $1,318.26 / $3,388.44	Professional		$512.86	$1,318.26	$3,388.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,348.96 / $1,479.11	Professional		$1,122.02	$1,348.96	$1,479.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $794.33 / $1,949.84	Professional		$537.03	$794.33	$1,949.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $9,772.37 / $33,884.42	Facility		$1,047.13	$9,772.37	$33,884.42
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $30,199.52 / $30,199.52 / $30,199.52	Facility	52	$30,199.52	$30,199.52	$30,199.52
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $7,585.78 / $7,585.78 / $7,585.78	Facility	53	$7,585.78	$7,585.78	$7,585.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,122.02 / $2,137.96	Professional		$660.69	$1,122.02	$2,137.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,348.96 / $2,238.72	Professional		$1,148.15	$1,348.96	$2,238.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,548.82	Professional		$1,122.02	$1,122.02	$1,548.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $870.96 / $1,202.26	Professional		$501.19	$870.96	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $16,595.87 / $33,884.42	Facility		$8,511.38	$16,595.87	$33,884.42
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $912.01 / $1,737.80	Professional		$645.65	$912.01	$1,737.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,148.15 / $1,348.96	Professional		$912.01	$1,148.15	$1,348.96