Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $818.26 / $1,476.66 / $2,065.52	Facility		$818.26	$1,476.66	$2,065.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $584.47 / $584.47 / $736.28	Professional		$584.47	$584.47	$736.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $872.26 / $1,378.71 / $1,723.39	Professional		$872.26	$1,378.71	$1,723.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $645.19 / $1,138.58 / $1,428.50	Professional		$645.19	$1,138.58	$1,428.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $759.05 / $986.77 / $3,075.27	Facility		$759.05	$986.77	$3,075.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $455.43 / $759.05 / $2,589.19	Professional		$455.43	$759.05	$2,589.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $911.62 / $1,391.79 / $1,663.52	Facility		$911.62	$1,391.79	$1,663.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $910.86 / $1,366.29 / $1,935.58	Professional		$910.86	$1,366.29	$1,935.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $759.05 / $759.05 / $1,354.90	Professional		$759.05	$759.05	$1,354.90
United Facility/Professional Facility Modifier Low / Median / High Price $1,138.58 / $1,138.58 / $1,138.58	Facility		$1,138.58	$1,138.58	$1,138.58
United Facility/Professional Professional Modifier Low / Median / High Price $455.43 / $470.61 / $1,745.82	Professional		$455.43	$470.61	$1,745.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $599.65 / $759.05 / $759.05	Professional		$599.65	$759.05	$759.05