Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $486.08 / $877.20 / $1,406.61	Facility		$486.08	$877.20	$1,406.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.60 / $392.29 / $437.38	Professional		$297.60	$392.29	$437.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $541.09 / $819.26 / $1,024.08	Professional		$541.09	$819.26	$1,024.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $450.91 / $676.37 / $881.60	Professional		$450.91	$676.37	$881.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $450.91 / $581.86 / $1,037.08	Facility		$450.91	$581.86	$1,037.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $270.55 / $450.91 / $1,752.64	Professional		$270.55	$450.91	$1,752.64
Midlands Facility/Professional Facility Modifier Low / Median / High Price $541.09 / $735.59 / $988.21	Facility		$541.09	$735.59	$988.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $541.09 / $811.64 / $988.21	Professional		$541.09	$811.64	$988.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $450.91 / $450.91 / $804.87	Professional		$450.91	$450.91	$804.87
United Facility/Professional Professional Modifier Low / Median / High Price $270.55 / $270.55 / $924.63	Professional		$270.55	$270.55	$924.63
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $450.91 / $450.91 / $450.91	Professional		$450.91	$450.91	$450.91