Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $501.19 / $707.95	Professional		$398.11	$501.19	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $851.14 / $1,318.26	Professional		$467.74	$851.14	$1,318.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $870.96 / $1,513.56	Professional		$467.74	$870.96	$1,513.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $776.25 / $1,148.15	Facility		$478.63	$776.25	$1,148.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $891.25 / $3,630.78	Professional		$478.63	$891.25	$3,630.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,047.13 / $1,318.26	Professional		$776.25	$1,047.13	$1,318.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $912.01 / $1,318.26	Professional		$741.31	$912.01	$1,318.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $933.25 / $1,202.26	Professional		$512.86	$933.25	$1,202.26
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $691.83 / $1,202.26	Professional		$467.74	$691.83	$1,202.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $912.01 / $1,071.52	Professional		$724.44	$912.01	$1,071.52