Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $801.90 / $801.90 / $1,322.15	Facility		$801.90	$801.90	$1,322.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $581.26 / $1,145.40	Professional		$575.50	$581.26	$1,145.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $644.80 / $855.53	Professional		$575.50	$644.80	$855.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $1,041.66 / $1,815.54	Professional		$575.50	$1,041.66	$1,815.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $606.35 / $788.26 / $1,145.40	Facility		$606.35	$788.26	$1,145.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $606.35 / $666.99 / $2,905.58	Professional		$606.35	$666.99	$2,905.58
Midlands Facility/Professional Facility Modifier Low / Median / High Price $727.62 / $987.15 / $1,457.78	Facility		$727.62	$987.15	$1,457.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $560.92 / $759.45 / $1,815.41	Professional		$560.92	$759.45	$1,815.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $1,140.44 / $1,202.17	Professional		$575.50	$1,140.44	$1,202.17
United Facility/Professional Professional Modifier Low / Median / High Price $575.50 / $592.77 / $684.85	Professional		$575.50	$592.77	$684.85
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $606.35 / $606.35 / $606.35	Facility		$606.35	$606.35	$606.35
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $479.02 / $606.35 / $606.35	Professional		$479.02	$606.35	$606.35