Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,271.22 / $5,321.95 / $9,071.11	Facility		$4,271.22	$5,321.95	$9,071.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,429.89 / $5,198.92	Professional		$2,429.89	$2,429.89	$5,198.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,475.75 / $2,475.75 / $2,475.75	Facility		$2,475.75	$2,475.75	$2,475.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,636.20 / $3,137.37	Professional		$2,429.89	$2,636.20	$3,137.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,814.40 / $2,766.21 / $5,625.00	Professional		$1,814.40	$2,766.21	$5,625.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,440.69 / $2,929.79 / $4,124.78	Facility		$2,440.69	$2,929.79	$4,124.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,440.69 / $2,717.01 / $10,655.19	Professional		$2,440.69	$2,717.01	$10,655.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,696.13 / $3,137.86 / $4,826.72	Facility		$2,696.13	$3,137.86	$4,826.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,211.92 / $2,929.79 / $4,970.38	Professional		$2,211.92	$2,929.79	$4,970.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,447.10 / $4,815.20 / $5,075.84	Professional		$2,447.10	$4,815.20	$5,075.84
United Facility/Professional Professional Modifier Low / Median / High Price $2,429.89 / $2,502.79 / $2,891.57	Professional		$2,429.89	$2,502.79	$2,891.57
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $2,440.69 / $2,440.69 / $2,440.69	Facility		$2,440.69	$2,440.69	$2,440.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,928.15 / $2,440.69 / $2,440.69	Professional		$1,928.15	$2,440.69	$2,440.69