Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.57 / $666.44 / $3,241.80	Facility		$302.57	$666.44	$3,241.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.81 / $688.19 / $1,252.28	Professional		$123.81	$688.19	$1,252.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,744.00 / $1,744.00 / $1,744.00	Facility		$1,744.00	$1,744.00	$1,744.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.54 / $668.40 / $1,901.78	Professional		$147.54	$668.40	$1,901.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $129.53 / $800.25 / $1,158.76	Professional		$129.53	$800.25	$1,158.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $177.30 / $552.63 / $1,876.04	Facility		$177.30	$552.63	$1,876.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $564.53 / $1,427.78 / $5,036.20	Professional		$564.53	$1,427.78	$5,036.20
Midlands Facility/Professional Facility Modifier Low / Median / High Price $280.27 / $1,371.35 / $2,058.42	Facility		$280.27	$1,371.35	$2,058.42
Midlands Facility/Professional Professional Modifier Low / Median / High Price $258.48 / $1,173.98 / $2,058.42	Professional		$258.48	$1,173.98	$2,058.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.36 / $636.34 / $1,387.30	Professional		$123.36	$636.34	$1,387.30
United Facility/Professional Professional Modifier Low / Median / High Price $710.35 / $1,020.61 / $1,922.11	Professional		$710.35	$1,020.61	$1,922.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $255.30 / $312.39 / $1,588.70	Professional		$255.30	$312.39	$1,588.70