Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $372.53 / $672.28 / $1,468.43	Facility		$372.53	$672.28	$1,468.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.08 / $300.64 / $335.20	Professional		$228.08	$300.64	$335.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $415.03 / $627.34 / $784.18	Professional		$415.03	$627.34	$784.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $345.57 / $570.19 / $2,176.23	Professional		$345.57	$570.19	$2,176.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $345.57 / $449.24 / $969.12	Facility		$345.57	$449.24	$969.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $207.34 / $355.94 / $1,727.85	Professional		$207.34	$355.94	$1,727.85
Midlands Facility/Professional Facility Modifier Low / Median / High Price $414.68 / $704.03 / $969.12	Facility		$414.68	$704.03	$969.12
Midlands Facility/Professional Professional Modifier Low / Median / High Price $415.03 / $704.03 / $990.02	Professional		$415.03	$704.03	$990.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $345.57 / $345.57 / $616.84	Professional		$345.57	$345.57	$616.84
United Facility/Professional Professional Modifier Low / Median / High Price $207.34 / $207.34 / $837.03	Professional		$207.34	$207.34	$837.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $345.57 / $345.57 / $345.57	Professional		$345.57	$345.57	$345.57