Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $977.24	Facility		$398.11	$398.11	$977.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $457.09 / $933.25	Professional		$371.54	$457.09	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,819.70 / $1,905.46	Facility		$1,778.28	$1,819.70	$1,905.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $912.01 / $1,174.90	Professional		$512.86	$912.01	$1,174.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $562.34 / $1,548.82	Professional		$331.13	$562.34	$1,548.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $1,023.29 / $3,630.78	Facility		$575.44	$1,023.29	$3,630.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $794.33 / $4,265.80	Professional		$467.74	$794.33	$4,265.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,000.00 / $1,174.90	Professional		$758.58	$1,000.00	$1,174.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility		$1,905.46	$1,905.46	$1,905.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $870.96 / $1,174.90	Professional		$724.44	$870.96	$1,174.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $288.40 / $645.65	Professional		$138.04	$288.40	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,258.93 / $1,698.24	Facility		$707.95	$1,258.93	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $676.08 / $1,288.25	Professional		$446.68	$676.08	$1,288.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $831.76 / $977.24	Professional		$831.76	$831.76	$977.24