Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.91 / $712.44 / $1,334.40	Facility		$363.91	$712.44	$1,334.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.92 / $362.60 / $2,563.19	Professional		$320.92	$362.60	$2,563.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $510.46 / $757.05 / $946.32	Professional		$510.46	$757.05	$946.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $416.78 / $605.00 / $754.37	Professional		$416.78	$605.00	$754.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $416.78 / $559.02 / $1,168.83	Facility		$416.78	$559.02	$1,168.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $250.07 / $429.28 / $2,135.73	Professional		$250.07	$429.28	$2,135.73
Midlands Facility/Professional Facility Modifier Low / Median / High Price $500.14 / $849.13 / $1,193.55	Facility		$500.14	$849.13	$1,193.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $500.55 / $849.13 / $1,194.06	Professional		$500.55	$849.13	$1,194.06
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,388.68 / $10,645.13 / $18,387.08	Facility		$1,388.68	$10,645.13	$18,387.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $405.53 / $416.78 / $743.95	Professional		$405.53	$416.78	$743.95
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