Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,023.29 / $1,584.89	Facility		$416.87	$1,023.29	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $1,000.00	Professional		$794.33	$794.33	$1,000.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $537.03 / $758.58	Professional		$151.36	$537.03	$758.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $501.19 / $954.99	Facility		$416.87	$501.19	$954.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $416.87 / $1,737.80	Professional		$229.09	$416.87	$1,737.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $446.68 / $891.25	Professional		$416.87	$446.68	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $954.99	Facility		$416.87	$416.87	$954.99
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $229.09 / $954.99	Professional		$218.78	$229.09	$954.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87