Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $375.75 / $678.09 / $1,230.46	Facility		$375.75	$678.09	$1,230.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.05 / $303.25 / $338.10	Professional		$230.05	$303.25	$338.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $418.27 / $633.22 / $791.52	Professional		$418.27	$633.22	$791.52
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $348.56 / $575.12 / $1,040.75	Professional		$348.56	$575.12	$1,040.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $348.56 / $453.13 / $892.31	Facility		$348.56	$453.13	$892.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $209.14 / $354.65 / $1,533.15	Professional		$209.14	$354.65	$1,533.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $418.27 / $639.12 / $812.06	Facility		$418.27	$639.12	$812.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $418.27 / $639.12 / $849.34	Professional		$418.27	$639.12	$849.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $348.56 / $348.56 / $622.17	Professional		$348.56	$348.56	$622.17
United Facility/Professional Facility Modifier Low / Median / High Price $348.56 / $348.56 / $348.56	Facility		$348.56	$348.56	$348.56
United Facility/Professional Professional Modifier Low / Median / High Price $209.14 / $209.14 / $759.86	Professional		$209.14	$209.14	$759.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $348.56 / $348.56 / $348.56	Professional		$348.56	$348.56	$348.56