Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $634.84 / $1,235.03 / $1,727.53	Facility		$634.84	$1,235.03	$1,727.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $418.99 / $552.30 / $615.79	Professional		$418.99	$552.30	$615.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $761.81 / $1,153.50 / $1,441.87	Professional		$761.81	$1,153.50	$1,441.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $539.61 / $857.03 / $1,149.06	Professional		$539.61	$857.03	$1,149.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $634.84 / $825.29 / $1,746.08	Facility		$634.84	$825.29	$1,746.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.90 / $404.08 / $2,479.86	Professional		$380.90	$404.08	$2,479.86
Midlands Facility/Professional Facility Modifier Low / Median / High Price $761.81 / $1,110.97 / $1,638.24	Facility		$761.81	$1,110.97	$1,638.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $761.81 / $1,110.97 / $1,746.08	Professional		$761.81	$1,110.97	$1,746.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $634.84 / $634.84 / $1,133.19	Professional		$634.84	$634.84	$1,133.19
United Facility/Professional Professional Modifier Low / Median / High Price $380.90 / $380.90 / $1,299.83	Professional		$380.90	$380.90	$1,299.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $634.84 / $634.84 / $634.84	Professional		$634.84	$634.84	$634.84