Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $372.00 / $505.64 / $814.14	Facility		$372.00	$505.64	$814.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $249.44 / $268.61 / $346.95	Professional		$249.44	$268.61	$346.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $418.73 / $643.88 / $804.84	Professional		$418.73	$643.88	$804.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $738.30 / $738.30 / $738.30	Professional		$738.30	$738.30	$738.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $359.28 / $1,132.26 / $2,607.27	Facility		$359.28	$1,132.26	$2,607.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $363.06 / $462.34 / $721.98	Professional		$363.06	$462.34	$721.98
Midlands Facility/Professional Facility Modifier Low / Median / High Price $359.28 / $418.73 / $663.37	Facility		$359.28	$418.73	$663.37
Midlands Facility/Professional Professional Modifier Low / Median / High Price $351.54 / $472.09 / $721.98	Professional		$351.54	$472.09	$721.98
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $521.91 / $1,967.06 / $2,723.63	Facility		$521.91	$1,967.06	$2,723.63
United Facility/Professional Professional Modifier Low / Median / High Price $363.06 / $456.08 / $643.27	Professional		$363.06	$456.08	$643.27
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $735.00 / $735.00 / $735.00	Facility		$735.00	$735.00	$735.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $735.00 / $735.00 / $735.00	Professional		$735.00	$735.00	$735.00