Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $753.08 / $753.08 / $1,569.94	Professional		$753.08	$753.08	$1,569.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.49 / $554.72 / $693.40	Professional		$287.49	$554.72	$693.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $119.78 / $336.32 / $638.01	Professional		$119.78	$336.32	$638.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $318.08 / $524.75 / $5,260.89	Facility		$318.08	$524.75	$5,260.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $282.70 / $546.08 / $1,791.04	Professional		$282.70	$546.08	$1,791.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $306.24 / $573.26 / $1,813.25	Facility		$306.24	$573.26	$1,813.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $280.94 / $415.90 / $648.90	Professional		$280.94	$415.90	$648.90
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $175.08 / $175.08 / $175.08	Facility		$175.08	$175.08	$175.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $391.80 / $639.40	Professional		$5.00	$391.80	$639.40
United Facility/Professional Professional Modifier Low / Median / High Price $270.93 / $485.32 / $766.92	Professional		$270.93	$485.32	$766.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $243.40 / $286.30 / $534.79	Professional		$243.40	$286.30	$534.79