Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $302.00	Facility		$223.87	$223.87	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $630.96	Professional		$208.93	$245.47	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $954.99 / $977.24	Facility		$912.01	$954.99	$977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $616.60 / $758.58	Professional		$602.56	$616.60	$758.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $331.13 / $1,023.29	Professional		$208.93	$331.13	$1,023.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $645.65 / $1,071.52	Facility		$380.19	$645.65	$1,071.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $407.38 / $851.14	Professional		$257.04	$407.38	$851.14
Midlands Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $616.60 / $794.33	Professional		$489.78	$616.60	$794.33
Midlands Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $977.24 / $977.24	Facility		$977.24	$977.24	$977.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $588.84 / $645.65	Professional		$588.84	$588.84	$645.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $229.09 / $457.09	Professional		$32.36	$229.09	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $912.01 / $1,230.27	Facility		$524.81	$912.01	$1,230.27
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $309.03 / $676.08	Professional		$257.04	$309.03	$676.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $426.58 / $501.19	Professional		$338.84	$426.58	$501.19