Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $485.16 / $723.58 / $1,366.11	Facility		$485.16	$723.58	$1,366.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.68 / $336.48 / $336.48	Professional		$217.68	$336.48	$336.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $431.48 / $444.42 / $457.37	Facility		$431.48	$444.42	$457.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $415.45 / $530.58 / $663.22	Professional		$415.45	$530.58	$663.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $139.79 / $268.62 / $481.32	Professional		$139.79	$268.62	$481.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $230.03 / $476.08 / $652.95	Facility		$230.03	$476.08	$652.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $186.62 / $328.52 / $693.06	Professional		$186.62	$328.52	$693.06
Midlands Facility/Professional Facility Modifier Low / Median / High Price $227.33 / $415.45 / $605.29	Facility		$227.33	$415.45	$605.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $252.00 / $476.08 / $605.29	Professional		$252.00	$476.08	$605.29
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $533.69 / $1,379.07 / $2,382.03	Facility		$533.69	$1,379.07	$2,382.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $226.10 / $406.49 / $732.99	Professional		$226.10	$406.49	$732.99
United Facility/Professional Professional Modifier Low / Median / High Price $239.11 / $311.37 / $523.20	Professional		$239.11	$311.37	$523.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $328.17 / $415.40 / $488.70	Professional		$328.17	$415.40	$488.70