Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $383.86 / $383.86 / $855.43	Facility		$383.86	$383.86	$855.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $383.86 / $392.63 / $815.40	Professional		$383.86	$392.63	$815.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.81 / $392.63 / $485.90	Professional		$380.81	$392.63	$485.90
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $280.69 / $392.63 / $736.24	Professional		$280.69	$392.63	$736.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $388.83 / $575.60	Facility		$346.74	$388.83	$575.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $388.83 / $427.71 / $6,283.71	Professional		$388.83	$427.71	$6,283.71
Midlands Facility/Professional Facility Modifier Low / Median / High Price $390.34 / $560.65 / $654.10	Facility		$390.34	$560.65	$654.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $267.39 / $453.67 / $583.24	Professional		$267.39	$453.67	$583.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $392.63 / $777.45 / $820.17	Professional		$392.63	$777.45	$820.17
United Facility/Professional Facility Modifier Low / Median / High Price $392.63 / $392.63 / $392.63	Facility		$392.63	$392.63	$392.63
United Facility/Professional Professional Modifier Low / Median / High Price $392.63 / $404.41 / $482.93	Professional		$392.63	$404.41	$482.93
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $425.51 / $425.51 / $425.51	Facility		$425.51	$425.51	$425.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $336.15 / $425.51 / $425.51	Professional		$336.15	$425.51	$425.51