Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $954.99	Facility		$954.99	$954.99	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $741.31 / $933.25	Professional		$645.65	$741.31	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,513.56 / $1,905.46	Professional		$1,071.52	$1,513.56	$1,905.46
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $954.99 / $2,818.38	Professional		$691.83	$954.99	$2,818.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,122.02 / $1,778.28	Facility		$691.83	$1,122.02	$1,778.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,548.82 / $4,677.35	Professional		$831.76	$1,548.82	$4,677.35
Midlands Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,412.54 / $1,905.46	Professional		$724.44	$1,412.54	$1,905.46
Midlands Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $2,089.30	Professional		$724.44	$724.44	$2,089.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,778.28 / $2,089.30	Professional		$1,548.82	$1,778.28	$2,089.30
United Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $933.25 / $1,230.27	Facility		$537.03	$933.25	$1,230.27
United Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,258.93 / $2,089.30	Professional		$831.76	$1,258.93	$2,089.30
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Professional		$524.81	$524.81	$524.81