Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.07 / $786.95 / $1,116.48	Facility		$436.07	$786.95	$1,116.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.98 / $351.93 / $392.38	Professional		$266.98	$351.93	$392.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $485.42 / $735.05 / $918.82	Professional		$485.42	$735.05	$918.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $404.52 / $606.78 / $732.18	Professional		$404.52	$606.78	$732.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $404.52 / $485.82 / $930.40	Facility		$404.52	$485.82	$930.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $197.02 / $404.52 / $1,274.39	Professional		$197.02	$404.52	$1,274.39
Midlands Facility/Professional Facility Modifier Low / Median / High Price $485.42 / $566.33 / $886.54	Facility		$485.42	$566.33	$886.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $485.42 / $651.33 / $886.54	Professional		$485.42	$651.33	$886.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $404.52 / $404.52 / $722.07	Professional		$404.52	$404.52	$722.07
United Facility/Professional Professional Modifier Low / Median / High Price $197.02 / $242.71 / $748.36	Professional		$197.02	$242.71	$748.36
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $404.52 / $404.52 / $404.52	Professional		$404.52	$404.52	$404.52