Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $461.93 / $712.02 / $1,268.06	Professional		$461.93	$712.02	$1,268.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $675.96 / $1,303.04 / $1,876.48	Professional		$675.96	$1,303.04	$1,876.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $527.71 / $793.04 / $1,065.51	Professional		$527.71	$793.04	$1,065.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $429.94 / $907.71 / $1,694.94	Facility		$429.94	$907.71	$1,694.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $522.17 / $1,184.92 / $4,008.69	Professional		$522.17	$1,184.92	$4,008.69
Midlands Facility/Professional Facility Modifier Low / Median / High Price $678.63 / $1,184.92 / $1,694.94	Facility		$678.63	$1,184.92	$1,694.94
Midlands Facility/Professional Professional Modifier Low / Median / High Price $556.00 / $1,099.67 / $1,694.94	Professional		$556.00	$1,099.67	$1,694.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $225.46 / $706.44 / $1,278.26	Professional		$225.46	$706.44	$1,278.26
United Facility/Professional Professional Modifier Low / Median / High Price $594.83 / $1,095.14 / $1,471.51	Professional		$594.83	$1,095.14	$1,471.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,121.72 / $1,419.90 / $1,670.50	Professional		$1,121.72	$1,419.90	$1,670.50