Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $450.91 / $877.20 / $1,227.00	Facility		$450.91	$877.20	$1,227.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.60 / $347.20 / $437.38	Professional		$297.60	$347.20	$437.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $541.09 / $819.26 / $1,024.08	Professional		$541.09	$819.26	$1,024.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $383.27 / $608.73 / $2,304.65	Professional		$383.27	$608.73	$2,304.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $450.91 / $581.86 / $1,154.33	Facility		$450.91	$581.86	$1,154.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $270.55 / $302.56 / $1,694.18	Professional		$270.55	$302.56	$1,694.18
Midlands Facility/Professional Facility Modifier Low / Median / High Price $541.09 / $684.65 / $988.21	Facility		$541.09	$684.65	$988.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $541.09 / $824.60 / $1,176.88	Professional		$541.09	$824.60	$1,176.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $450.91 / $450.91 / $804.87	Professional		$450.91	$450.91	$804.87
United Facility/Professional Professional Modifier Low / Median / High Price $270.55 / $270.55 / $982.98	Professional		$270.55	$270.55	$982.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $450.91 / $450.91 / $450.91	Professional		$450.91	$450.91	$450.91