Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $864.21 / $1,173.15 / $1,366.42	Professional		$864.21	$1,173.15	$1,366.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,335.53 / $2,261.89 / $2,827.37	Professional		$1,335.53	$2,261.89	$2,827.37
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,093.22 / $1,578.77 / $5,899.40	Professional		$1,093.22	$1,578.77	$5,899.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $483.65 / $1,586.40 / $2,583.90	Facility		$483.65	$1,586.40	$2,583.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $968.10 / $2,274.61 / $6,610.61	Professional		$968.10	$2,274.61	$6,610.61
Midlands Facility/Professional Facility Modifier Low / Median / High Price $483.65 / $2,042.14 / $2,591.32	Facility		$483.65	$2,042.14	$2,591.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $483.65 / $1,879.00 / $2,591.32	Professional		$483.65	$1,879.00	$2,591.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,317.40 / $1,317.40 / $1,317.40	Professional		$1,317.40	$1,317.40	$1,317.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,109.60 / $2,001.28 / $2,743.77	Professional		$1,109.60	$2,001.28	$2,743.77
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,498.08 / $1,896.30 / $2,231.00	Professional		$1,498.08	$1,896.30	$2,231.00