Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,274.86 / $1,274.86 / $1,471.25	Facility		$1,274.86	$1,274.86	$1,471.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $752.69 / $1,075.90 / $1,682.15	Professional		$752.69	$1,075.90	$1,682.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,186.93 / $1,186.93 / $2,493.63	Facility		$1,186.93	$1,186.93	$2,493.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,186.93 / $2,127.00 / $2,658.75	Professional		$1,186.93	$2,127.00	$2,658.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,743.07 / $2,241.80 / $2,422.19	Professional		$1,743.07	$2,241.80	$2,422.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,424.09 / $2,610.31 / $9,309.60	Facility		$1,424.09	$2,610.31	$9,309.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $893.69 / $1,130.95 / $2,973.46	Professional		$893.69	$1,130.95	$2,973.46
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,486.34 / $2,493.63 / $2,988.64	Facility		$2,486.34	$2,493.63	$2,988.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,008.72 / $2,721.34 / $4,765.29	Professional		$2,008.72	$2,721.34	$4,765.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,871.51 / $2,312.28 / $4,046.49	Professional		$1,871.51	$2,312.28	$4,046.49
United Facility/Professional Facility Modifier Low / Median / High Price $1,193.78 / $1,193.78 / $1,193.78	Facility		$1,193.78	$1,193.78	$1,193.78
United Facility/Professional Professional Modifier Low / Median / High Price $885.71 / $1,130.95 / $2,385.25	Professional		$885.71	$1,130.95	$2,385.25
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $2,221.60 / $2,221.60 / $2,221.60	Facility		$2,221.60	$2,221.60	$2,221.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,755.06 / $2,221.60 / $2,221.60	Professional		$1,755.06	$2,221.60	$2,221.60