Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,174.90	Facility		$1,000.00	$1,000.00	$1,174.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $851.14 / $1,412.54	Professional		$660.69	$851.14	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,778.28	Facility		$1,122.02	$1,122.02	$1,778.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,862.09 / $2,290.87	Professional		$1,122.02	$1,862.09	$2,290.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,584.89 / $1,737.80	Professional		$1,348.96	$1,584.89	$1,737.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,862.09 / $7,413.10	Facility		$1,071.52	$1,862.09	$7,413.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $977.24 / $2,630.27	Professional		$707.95	$977.24	$2,630.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,819.70 / $2,137.96	Professional		$1,737.80	$1,819.70	$2,137.96
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Facility		$1,778.28	$1,778.28	$1,778.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,630.27 / $2,630.27	Professional		$1,621.81	$2,630.27	$2,630.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,089.30 / $3,467.37	Professional		$1,621.81	$2,089.30	$3,467.37
United Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,174.90 / $2,290.87	Facility		$549.54	$1,174.90	$2,290.87
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $794.33 / $1,445.44	Professional		$707.95	$794.33	$1,445.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,548.82 / $1,548.82	Professional		$1,230.27	$1,548.82	$1,548.82