Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $598.64 / $598.64 / $598.64	Facility		$598.64	$598.64	$598.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.91 / $496.87 / $598.64	Professional		$478.91	$496.87	$598.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $747.93 / $873.12 / $1,047.09	Facility		$747.93	$873.12	$1,047.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $508.84 / $599.14 / $599.14	Professional		$508.84	$599.14	$599.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $200.00 / $828.93	Professional		$150.00	$200.00	$828.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $478.91 / $626.17 / $873.12	Facility		$478.91	$626.17	$873.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $498.87 / $498.87 / $997.74	Professional		$498.87	$498.87	$997.74
Midlands Facility/Professional Facility Modifier Low / Median / High Price $737.35 / $822.72 / $938.45	Facility		$737.35	$822.72	$938.45
Midlands Facility/Professional Professional Modifier Low / Median / High Price $599.14 / $599.14 / $599.14	Professional		$599.14	$599.14	$599.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,734.56 / $1,846.35 / $2,082.01	Professional		$1,734.56	$1,846.35	$2,082.01
United Facility/Professional Professional Modifier Low / Median / High Price $498.87 / $498.87 / $538.78	Professional		$498.87	$498.87	$538.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $394.11 / $498.87 / $498.87	Professional		$394.11	$498.87	$498.87