Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $262.08 / $900.00 / $900.00	Facility		$262.08	$900.00	$900.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $238.46 / $5,282.63	Professional		$238.46	$238.46	$5,282.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.35 / $238.46 / $567.27	Professional		$148.35	$238.46	$567.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $208.41 / $431.61 / $5,706.73	Professional		$208.41	$431.61	$5,706.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.64 / $293.45 / $3,358.13	Facility		$173.64	$293.45	$3,358.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.64 / $193.30 / $16,586.83	Professional		$173.64	$193.30	$16,586.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $174.72 / $382.98 / $1,079.97	Facility		$174.72	$382.98	$1,079.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $174.72 / $331.92 / $5,302.27	Professional		$174.72	$331.92	$5,302.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $472.55 / $507.75	Professional		$238.46	$472.55	$507.75
United Facility/Professional Professional Modifier Low / Median / High Price $238.46 / $252.77 / $338.61	Professional		$238.46	$252.77	$338.61
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $190.02 / $190.02 / $190.02	Facility		$190.02	$190.02	$190.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $150.12 / $190.02 / $190.02	Professional		$150.12	$190.02	$190.02