Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $859.40 / $859.40 / $911.58	Facility		$859.40	$859.40	$911.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $496.84 / $663.80 / $1,110.71	Professional		$496.84	$663.80	$1,110.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $756.07 / $756.07 / $1,353.92	Facility		$756.07	$756.07	$1,353.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $756.07 / $1,434.00 / $1,792.50	Professional		$756.07	$1,434.00	$1,792.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,016.00 / $1,101.00 / $1,236.85	Professional		$1,016.00	$1,101.00	$1,236.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $773.21 / $1,460.98 / $5,761.13	Facility		$773.21	$1,460.98	$5,761.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $551.38 / $637.25 / $1,679.00	Professional		$551.38	$637.25	$1,679.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,349.96 / $1,353.92 / $1,679.00	Facility		$1,349.96	$1,353.92	$1,679.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,108.84 / $1,581.57 / $2,587.29	Professional		$1,108.84	$1,581.57	$2,587.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,236.85 / $1,324.68 / $2,241.00	Professional		$1,236.85	$1,324.68	$2,241.00
United Facility/Professional Professional Modifier Low / Median / High Price $546.46 / $614.04 / $1,448.14	Professional		$546.46	$614.04	$1,448.14
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,206.22 / $1,206.22 / $1,206.22	Facility		$1,206.22	$1,206.22	$1,206.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $952.91 / $1,206.22 / $1,206.22	Professional		$952.91	$1,206.22	$1,206.22