Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $891.25 / $891.25	Facility		$309.03	$891.25	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $316.23 / $891.25	Professional		$309.03	$316.23	$891.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $316.23 / $457.09	Professional		$309.03	$316.23	$457.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $2,398.83 / $3,981.07	Professional		$281.84	$2,398.83	$3,981.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $398.11 / $1,318.26	Facility		$302.00	$398.11	$1,318.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $338.84 / $6,025.60	Professional		$302.00	$338.84	$6,025.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $457.09 / $891.25	Professional		$346.74	$457.09	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,513.56 / $2,951.21	Professional		$758.58	$1,513.56	$2,951.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $602.56 / $724.44	Professional		$331.13	$602.56	$724.44
United Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $363.08	Professional		$309.03	$309.03	$363.08
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Facility		$363.08	$363.08	$363.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $363.08	Professional		$281.84	$363.08	$363.08