Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $828.12 / $828.12 / $900.94	Facility		$828.12	$828.12	$900.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $422.89 / $828.12	Professional		$422.89	$422.89	$828.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.74 / $462.58 / $547.51	Professional		$416.74	$462.58	$547.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $765.43 / $1,756.33	Professional		$422.89	$765.43	$1,756.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $409.52 / $519.83 / $866.21	Facility		$409.52	$519.83	$866.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $409.52 / $455.88 / $1,968.33	Professional		$409.52	$455.88	$1,968.33
Midlands Facility/Professional Facility Modifier Low / Median / High Price $479.85 / $556.24 / $799.74	Facility		$479.85	$556.24	$799.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $414.78 / $517.79 / $962.80	Professional		$414.78	$517.79	$962.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $838.02 / $883.38	Professional		$422.89	$838.02	$883.38
United Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $435.58 / $592.04	Professional		$422.89	$435.58	$592.04
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $448.15 / $448.15 / $448.15	Facility		$448.15	$448.15	$448.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $354.04 / $448.15 / $448.15	Professional		$354.04	$448.15	$448.15