Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.00 / $739.25 / $1,034.05	Facility		$380.00	$739.25	$1,034.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $330.60 / $330.60 / $330.60	Professional		$330.60	$330.60	$330.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.00 / $690.66 / $863.33	Professional		$456.00	$690.66	$863.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $323.00 / $513.00 / $1,942.23	Professional		$323.00	$513.00	$1,942.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $380.00 / $490.36 / $972.80	Facility		$380.00	$490.36	$972.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $228.00 / $254.98 / $1,427.76	Professional		$228.00	$254.98	$1,427.76
Midlands Facility/Professional Facility Modifier Low / Median / High Price $456.00 / $576.98 / $832.80	Facility		$456.00	$576.98	$832.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $456.00 / $694.93 / $991.80	Professional		$456.00	$694.93	$991.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $380.00 / $380.00 / $678.30	Professional		$380.00	$380.00	$678.30
United Facility/Professional Facility Modifier Low / Median / High Price $570.00 / $570.00 / $570.00	Facility		$570.00	$570.00	$570.00
United Facility/Professional Professional Modifier Low / Median / High Price $228.00 / $228.00 / $778.05	Professional		$228.00	$228.00	$778.05
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $380.00 / $380.00 / $380.00	Professional		$380.00	$380.00	$380.00