Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $3,162.28	Facility		$2,041.74	$2,041.74	$3,162.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,949.84 / $3,467.37	Professional		$1,479.11	$1,949.84	$3,467.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $3,630.78	Facility		$1,995.26	$1,995.26	$3,630.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $4,265.80 / $5,370.32	Professional		$1,995.26	$4,265.80	$5,370.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,801.89 / $4,168.69	Professional		$3,090.30	$3,801.89	$4,168.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $4,168.69 / $17,378.01	Facility		$2,187.76	$4,168.69	$17,378.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,041.74 / $5,370.32	Professional		$1,548.82	$2,041.74	$5,370.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $3,548.13 / $3,715.35 / $4,897.79	Professional		$3,548.13	$3,715.35	$4,897.79
Midlands Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility		$3,630.78	$3,630.78	$3,630.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $3,715.35 / $5,370.32 / $5,370.32	Professional		$3,715.35	$5,370.32	$5,370.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,570.88 / $7,079.46	Professional		$3,311.31	$4,570.88	$7,079.46
United Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,691.53 / $5,248.07	Facility		$1,230.27	$2,691.53	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,621.81 / $3,090.30	Professional		$1,548.82	$1,621.81	$3,090.30
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $3,090.30 / $3,090.30	Professional		$2,398.83	$3,090.30	$3,090.30