Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $426.58 / $1,698.24	Professional		$269.15	$426.58	$1,698.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $575.44 / $794.33	Professional		$302.00	$575.44	$794.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $794.33 / $2,137.96	Professional		$323.59	$794.33	$2,137.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $436.52 / $776.25	Facility		$269.15	$436.52	$776.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $512.86 / $5,754.40	Professional		$338.84	$512.86	$5,754.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $676.08 / $891.25	Professional		$489.78	$676.08	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $724.44 / $912.01	Professional		$575.44	$724.44	$912.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $537.03 / $676.08	Professional		$302.00	$537.03	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $426.58 / $741.31	Professional		$338.84	$426.58	$741.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $676.08 / $676.08	Professional		$537.03	$676.08	$676.08