Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,737.80 / $1,862.09	Facility		$776.25	$1,737.80	$1,862.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $588.84 / $831.76	Professional		$489.78	$588.84	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,380.38 / $1,737.80	Professional		$870.96	$1,380.38	$1,737.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $851.14 / $2,570.40	Professional		$630.96	$851.14	$2,570.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,096.48 / $1,513.56	Facility		$616.60	$1,096.48	$1,513.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $1,174.90 / $3,801.89	Professional		$630.96	$1,174.90	$3,801.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $1,174.90 / $1,513.56	Professional		$616.60	$1,174.90	$1,513.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $1,445.44	Professional		$616.60	$616.60	$1,445.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,202.26 / $1,412.54	Professional		$1,071.52	$1,202.26	$1,412.54
United Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $933.25 / $1,230.27	Facility		$537.03	$933.25	$1,230.27
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $933.25 / $1,548.82	Professional		$602.56	$933.25	$1,548.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Professional		$524.81	$524.81	$524.81