Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $405.08 / $405.08 / $766.96	Facility		$405.08	$405.08	$766.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $356.93 / $356.93 / $708.95	Professional		$356.93	$356.93	$708.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.93 / $356.93 / $440.56	Professional		$344.93	$356.93	$440.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $247.10 / $356.93 / $648.13	Professional		$247.10	$356.93	$648.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $348.62 / $405.08 / $589.16	Facility		$348.62	$405.08	$589.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $348.62 / $388.09 / $1,496.24	Professional		$348.62	$388.09	$1,496.24
Midlands Facility/Professional Facility Modifier Low / Median / High Price $406.24 / $510.52 / $634.84	Facility		$406.24	$510.52	$634.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $406.24 / $440.56 / $522.91	Professional		$406.24	$440.56	$522.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $357.02 / $707.31 / $745.60	Professional		$357.02	$707.31	$745.60
United Facility/Professional Professional Modifier Low / Median / High Price $356.93 / $367.64 / $424.75	Professional		$356.93	$367.64	$424.75
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $381.50 / $381.50 / $381.50	Facility		$381.50	$381.50	$381.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $301.39 / $381.50 / $381.50	Professional		$301.39	$381.50	$381.50