Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $301.35 / $537.79 / $820.03	Facility		$301.35	$537.79	$820.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.04 / $262.17 / $809.08	Professional		$232.04	$262.17	$809.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $361.92 / $547.70 / $684.62	Professional		$361.92	$547.70	$684.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $331.49 / $527.36 / $683.67	Professional		$331.49	$527.36	$683.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $301.35 / $361.92 / $693.11	Facility		$301.35	$361.92	$693.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $180.81 / $301.35 / $972.49	Professional		$180.81	$301.35	$972.49
Midlands Facility/Professional Facility Modifier Low / Median / High Price $361.62 / $552.54 / $669.68	Facility		$361.62	$552.54	$669.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $361.62 / $552.54 / $702.15	Professional		$361.62	$552.54	$702.15
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,075.18 / $1,075.18 / $1,075.18	Facility		$1,075.18	$1,075.18	$1,075.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $301.35 / $301.35 / $537.91	Professional		$301.35	$301.35	$537.91
United Facility/Professional Professional Modifier Low / Median / High Price $180.81 / $180.81 / $617.01	Professional		$180.81	$180.81	$617.01
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $301.35 / $301.35 / $301.35	Professional		$301.35	$301.35	$301.35