Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,584.89	Facility		$1,348.96	$1,348.96	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,174.90 / $1,905.46	Professional		$912.01	$1,174.90	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $2,454.71	Facility		$1,202.26	$1,202.26	$2,454.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $2,511.89 / $3,162.28	Professional		$1,202.26	$2,511.89	$3,162.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,187.76 / $2,344.23	Professional		$2,041.74	$2,187.76	$2,344.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,570.40 / $10,232.93	Facility		$1,479.11	$2,570.40	$10,232.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,318.26 / $3,630.78	Professional		$977.24	$1,318.26	$3,630.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,454.71 / $2,951.21	Professional		$2,398.83	$2,454.71	$2,951.21
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Facility		$2,454.71	$2,454.71	$2,454.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,238.72 / $3,630.78 / $3,630.78	Professional		$2,238.72	$3,630.78	$3,630.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,187.76 / $2,884.03 / $4,677.35	Professional		$2,187.76	$2,884.03	$4,677.35
United Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,621.81 / $3,162.28	Facility		$741.31	$1,621.81	$3,162.28
United Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,071.52 / $1,995.26	Professional		$954.99	$1,071.52	$1,995.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,041.74 / $2,041.74	Professional		$1,621.81	$2,041.74	$2,041.74