Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $602.56 / $602.56	Facility		$426.58	$602.56	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $426.58 / $2,630.27	Professional		$316.23	$426.58	$2,630.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,202.26 / $1,230.27	Facility		$1,174.90	$1,202.26	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,023.29 / $1,288.25	Professional		$912.01	$1,023.29	$1,288.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $562.34 / $1,348.96	Professional		$380.19	$562.34	$1,348.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $933.25 / $1,548.82	Facility		$549.54	$933.25	$1,548.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $575.44 / $1,479.11	Professional		$380.19	$575.44	$1,479.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $912.01 / $1,122.02	Professional		$831.76	$912.01	$1,122.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Facility		$1,230.27	$1,230.27	$1,230.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,122.02	Professional		$1,000.00	$1,000.00	$1,122.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $371.54 / $724.44	Professional		$204.17	$371.54	$724.44
United Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,380.38 / $1,819.70	Facility		$794.33	$1,380.38	$1,819.70
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $489.78 / $870.96	Professional		$371.54	$489.78	$870.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $794.33 / $933.25	Professional		$616.60	$794.33	$933.25