Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,327.86 / $2,830.80 / $2,830.80	Facility		$2,327.86	$2,830.80	$2,830.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,494.41 / $1,494.41 / $2,830.80	Professional		$1,494.41	$1,494.41	$2,830.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,784.81 / $1,784.81 / $1,917.39	Facility		$1,784.81	$1,784.81	$1,917.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,519.72 / $1,859.24 / $2,080.58	Professional		$1,519.72	$1,859.24	$2,080.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,195.53 / $1,494.41 / $2,704.88	Professional		$1,195.53	$1,494.41	$2,704.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,542.24 / $2,080.79 / $2,961.02	Facility		$1,542.24	$2,080.79	$2,961.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,542.24 / $1,542.24 / $3,084.48	Professional		$1,542.24	$1,542.24	$3,084.48
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,280.00 / $1,824.69 / $2,400.91	Facility		$1,280.00	$1,824.69	$2,400.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,519.72 / $1,850.69 / $2,080.79	Professional		$1,519.72	$1,850.69	$2,080.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,929.60 / $2,109.40 / $2,325.10	Professional		$1,929.60	$2,109.40	$2,325.10
United Facility/Professional Professional Modifier Low / Median / High Price $1,494.41 / $1,494.41 / $1,643.85	Professional		$1,494.41	$1,494.41	$1,643.85
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,542.24 / $1,542.24 / $1,542.24	Facility		$1,542.24	$1,542.24	$1,542.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,218.36 / $1,542.24 / $1,542.24	Professional		$1,218.36	$1,542.24	$1,542.24