Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $7,413.10	Facility		$1,230.27	$1,230.27	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,047.13 / $6,165.95	Professional		$1,000.00	$1,047.13	$6,165.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $933.25 / $1,949.84	Facility		$776.25	$933.25	$1,949.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,288.25 / $1,621.81	Professional		$1,096.48	$1,288.25	$1,621.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $1,819.70 / $2,290.87	Professional		$275.42	$1,819.70	$2,290.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,288.25 / $2,454.71	Facility		$1,000.00	$1,288.25	$2,454.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,819.70	Professional		$1,023.29	$1,023.29	$1,819.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Professional		$1,122.02	$1,122.02	$1,122.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,000.00 / $2,137.96	Facility		$794.33	$1,000.00	$2,137.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Professional		$1,122.02	$1,122.02	$1,122.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,344.23 / $2,630.27 / $3,162.28	Professional		$2,344.23	$2,630.27	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $1.02 / $1,023.29 / $1,698.24	Facility		$1.02	$1,023.29	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,096.48 / $1,148.15	Professional		$1,023.29	$1,096.48	$1,148.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Professional		$1,023.29	$1,023.29	$1,023.29