Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $933.25 / $933.25	Facility		$741.31	$933.25	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $776.25 / $954.99	Professional		$741.31	$776.25	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $4,265.80 / $4,786.30	Professional		$812.83	$4,265.80	$4,786.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $1,000.00 / $1,174.90	Professional		$151.36	$1,000.00	$1,174.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $3,311.31	Facility		$501.19	$501.19	$3,311.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $1,548.82	Professional		$776.25	$776.25	$1,548.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Professional		$4,786.30	$4,786.30	$4,786.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Professional		$4,786.30	$4,786.30	$4,786.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,238.72 / $2,630.27	Professional		$1,949.84	$2,238.72	$2,630.27
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $954.99	Professional		$794.33	$794.33	$954.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $3,630.78 / $4,570.88 / $4,570.88	Professional		$3,630.78	$4,570.88	$4,570.88