Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $361.54 / $652.44 / $1,425.15	Facility		$361.54	$652.44	$1,425.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.35 / $291.77 / $325.32	Professional		$221.35	$291.77	$325.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $402.79 / $609.05 / $761.33	Professional		$402.79	$609.05	$761.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $335.38 / $553.38 / $920.76	Professional		$335.38	$553.38	$920.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $335.38 / $435.99 / $940.54	Facility		$335.38	$435.99	$940.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $201.23 / $345.44 / $1,676.90	Professional		$201.23	$345.44	$1,676.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $402.46 / $683.28 / $940.54	Facility		$402.46	$683.28	$940.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $402.79 / $683.28 / $960.83	Professional		$402.79	$683.28	$960.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $335.38 / $335.38 / $598.65	Professional		$335.38	$335.38	$598.65
United Facility/Professional Professional Modifier Low / Median / High Price $201.23 / $201.23 / $812.38	Professional		$201.23	$201.23	$812.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $335.38 / $335.38 / $335.38	Professional		$335.38	$335.38	$335.38