Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $923.00 / $923.00 / $923.00	Facility		$923.00	$923.00	$923.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $738.40 / $766.09 / $965.27	Professional		$738.40	$766.09	$965.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $784.55 / $784.55 / $4,821.97	Professional		$784.55	$784.55	$4,821.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $1,150.15 / $1,174.41	Professional		$150.00	$1,150.15	$1,174.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $498.67 / $923.00 / $1,247.90	Facility		$498.67	$923.00	$1,247.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $769.17 / $769.17 / $1,339.43	Professional		$769.17	$769.17	$1,339.43
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,040.60 / $1,214.05 / $1,671.91	Facility		$1,040.60	$1,214.05	$1,671.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $4,821.97 / $4,821.97 / $4,821.97	Professional		$4,821.97	$4,821.97	$4,821.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $989.85 / $1,863.24 / $2,100.75	Professional		$989.85	$1,863.24	$2,100.75
United Facility/Professional Facility Modifier Low / Median / High Price $0.77 / $0.77 / $0.77	Facility		$0.77	$0.77	$0.77
United Facility/Professional Professional Modifier Low / Median / High Price $769.17 / $769.17 / $846.09	Professional		$769.17	$769.17	$846.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $3,645.85 / $4,615.00 / $4,615.00	Professional		$3,645.85	$4,615.00	$4,615.00