Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $3,090.30 / $6,760.83	Facility		$380.19	$3,090.30	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $602.56 / $1,445.44	Professional		$257.04	$602.56	$1,445.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $1,380.38 / $1,698.24	Professional		$588.84	$1,380.38	$1,698.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $933.25 / $3,311.31	Professional		$257.04	$933.25	$3,311.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,513.56 / $8,511.38	Facility		$575.44	$1,513.56	$8,511.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,230.27 / $5,623.41	Professional		$602.56	$1,230.27	$5,623.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $1,202.26 / $1,621.81	Professional		$501.19	$1,202.26	$1,621.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $691.83 / $1,659.59	Professional		$501.19	$691.83	$1,659.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $1,071.52 / $1,659.59	Professional		$5.01	$1,071.52	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $6,456.54 / $9,332.54	Facility		$4,365.16	$6,456.54	$9,332.54
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $660.69 / $1,778.28	Professional		$309.03	$660.69	$1,778.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $588.84 / $1,318.26	Professional		$501.19	$588.84	$1,318.26