Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,471.91 / $1,471.91 / $3,002.09	Facility		$1,471.91	$1,471.91	$3,002.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,323.35 / $3,676.31	Professional		$1,323.35	$1,323.35	$3,676.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,471.80 / $2,166.83	Professional		$1,323.35	$1,471.80	$2,166.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,029.19 / $1,323.35 / $2,193.36	Professional		$1,029.19	$1,323.35	$2,193.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,368.83 / $1,471.91 / $2,326.78	Facility		$1,368.83	$1,471.91	$2,326.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,376.79 / $1,532.66 / $6,148.12	Professional		$1,376.79	$1,532.66	$6,148.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,436.12 / $2,088.78 / $2,659.51	Facility		$1,436.12	$2,088.78	$2,659.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,436.12 / $1,810.27 / $2,372.44	Professional		$1,436.12	$1,810.27	$2,372.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $2,622.42 / $2,764.37	Professional		$1,323.35	$2,622.42	$2,764.37
United Facility/Professional Professional Modifier Low / Median / High Price $1,323.35 / $1,363.05 / $1,574.79	Professional		$1,323.35	$1,363.05	$1,574.79
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,506.67 / $1,506.67 / $1,506.67	Facility		$1,506.67	$1,506.67	$1,506.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,190.27 / $1,506.67 / $1,506.67	Professional		$1,190.27	$1,506.67	$1,506.67