Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.61 / $365.61 / $1,179.55	Facility		$365.61	$365.61	$1,179.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.61 / $1,248.00 / $1,294.80	Professional		$365.61	$1,248.00	$1,294.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.40 / $471.47 / $1,326.00	Professional		$220.40	$471.47	$1,326.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $226.68 / $720.80 / $1,066.40	Professional		$226.68	$720.80	$1,066.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $203.78 / $365.61 / $572.82	Facility		$203.78	$365.61	$572.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $419.08 / $1,339.00 / $1,592.50	Professional		$419.08	$1,339.00	$1,592.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $203.78 / $254.73 / $610.79	Facility		$203.78	$254.73	$610.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $203.78 / $334.57 / $576.49	Professional		$203.78	$334.57	$576.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $238.80 / $498.90 / $646.10	Professional		$238.80	$498.90	$646.10
United Facility/Professional Professional Modifier Low / Median / High Price $1,300.00 / $1,365.00 / $1,547.00	Professional		$1,300.00	$1,365.00	$1,547.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $405.11 / $405.11 / $405.11	Facility		$405.11	$405.11	$405.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $320.04 / $405.11 / $405.11	Professional		$320.04	$405.11	$405.11