Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.50 / $449.29 / $1,126.43	Facility		$212.50	$449.29	$1,126.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.07 / $404.28 / $1,475.00	Professional		$275.07	$404.28	$1,475.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $500.55 / $756.60 / $945.74	Professional		$500.55	$756.60	$945.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $458.46 / $727.80 / $754.37	Professional		$458.46	$727.80	$754.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $558.90 / $1,158.32	Facility		$416.78	$558.90	$1,158.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $250.07 / $429.28 / $2,083.90	Professional		$250.07	$429.28	$2,083.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $500.14 / $849.13 / $1,192.05	Facility		$500.14	$849.13	$1,192.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $500.55 / $849.13 / $1,148.68	Professional		$500.55	$849.13	$1,148.68
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,249.89 / $1,249.89 / $1,249.89	Facility		$1,249.89	$1,249.89	$1,249.89
United Facility/Professional Professional Modifier Low / Median / High Price $250.07 / $250.07 / $1,009.54	Professional		$250.07	$250.07	$1,009.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $416.78 / $416.78	Professional		$416.78	$416.78	$416.78