Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $719.32 / $1,803.44 / $2,262.78	Facility		$719.32	$1,803.44	$2,262.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,803.44 / $1,803.44 / $1,803.44	Professional		$1,803.44	$1,803.44	$1,803.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,573.90 / $1,573.90 / $1,967.37	Professional		$1,573.90	$1,573.90	$1,967.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $932.40 / $1,234.18 / $2,457.00	Professional		$932.40	$1,234.18	$2,457.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $503.84 / $817.87 / $1,498.83	Facility		$503.84	$817.87	$1,498.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $368.10 / $506.31 / $1,498.83	Professional		$368.10	$506.31	$1,498.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $724.85 / $1,498.83	Facility		$500.00	$724.85	$1,498.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $652.90 / $742.21 / $1,412.79	Professional		$652.90	$742.21	$1,412.79
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,088.63 / $7,435.89 / $12,843.81	Facility		$1,088.63	$7,435.89	$12,843.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $616.46 / $1,132.03 / $1,276.95	Professional		$616.46	$1,132.03	$1,276.95
United Facility/Professional Facility Modifier Low / Median / High Price $745.40 / $1,219.63 / $1,485.61	Facility		$745.40	$1,219.63	$1,485.61
United Facility/Professional Professional Modifier Low / Median / High Price $368.10 / $442.99 / $682.24	Professional		$368.10	$442.99	$682.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $456.99 / $578.47 / $578.47	Professional		$456.99	$578.47	$578.47