Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $720.00 / $1,284.93 / $1,959.25	Facility		$720.00	$1,284.93	$1,959.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $554.40 / $698.40	Professional		$200.00	$554.40	$698.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $864.00 / $1,307.56 / $1,634.45	Professional		$864.00	$1,307.56	$1,634.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $612.00 / $972.00 / $1,303.20	Professional		$612.00	$972.00	$1,303.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $684.00 / $929.11 / $1,843.20	Facility		$684.00	$929.11	$1,843.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $432.00 / $720.00 / $2,832.55	Professional		$432.00	$720.00	$2,832.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $864.00 / $1,370.68 / $2,032.35	Facility		$864.00	$1,370.68	$2,032.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $864.00 / $1,397.52 / $1,836.00	Professional		$864.00	$1,397.52	$1,836.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $700.56 / $720.00 / $1,285.20	Professional		$700.56	$720.00	$1,285.20
United Facility/Professional Professional Modifier Low / Median / High Price $432.00 / $432.00 / $1,569.60	Professional		$432.00	$432.00	$1,569.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $720.00 / $720.00 / $720.00	Professional		$720.00	$720.00	$720.00