Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $790.80 / $790.80 / $814.52	Facility		$790.80	$790.80	$814.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $695.90 / $695.90 / $790.80	Professional		$695.90	$695.90	$790.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $639.79 / $739.40 / $799.73	Professional		$639.79	$739.40	$799.73
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $1,250.86 / $1,277.25	Professional		$150.00	$1,250.86	$1,277.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $140.71 / $827.18 / $1,585.02	Facility		$140.71	$827.18	$1,585.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $107.25 / $1,113.75	Professional		$85.80	$107.25	$1,113.75
Midlands Facility/Professional Facility Modifier Low / Median / High Price $815.13 / $1,103.33 / $1,746.08	Facility		$815.13	$1,103.33	$1,746.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $140.71 / $1,103.33 / $1,746.08	Professional		$140.71	$1,103.33	$1,746.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,737.32 / $1,847.21 / $1,959.64	Professional		$1,737.32	$1,847.21	$1,959.64
United Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $85.80 / $147.29	Professional		$85.80	$85.80	$147.29
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $92.56 / $117.16 / $117.16	Professional		$92.56	$117.16	$117.16