Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $831.76	Facility		$758.58	$758.58	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $630.96 / $1,122.02	Professional		$478.63	$630.96	$1,122.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $1,348.96	Facility		$707.95	$707.95	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,380.38 / $1,737.80	Professional		$707.95	$1,380.38	$1,737.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,096.48 / $1,202.26	Professional		$1,023.29	$1,096.48	$1,202.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,412.54 / $5,754.40	Facility		$831.76	$1,412.54	$5,754.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $741.31 / $1,995.26	Professional		$537.03	$741.31	$1,995.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,380.38 / $1,621.81	Professional		$1,318.26	$1,380.38	$1,621.81
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility		$1,348.96	$1,348.96	$1,348.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,995.26 / $1,995.26	Professional		$1,230.27	$1,995.26	$1,995.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,584.89 / $2,630.27	Professional		$1,230.27	$1,584.89	$2,630.27
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $891.25 / $1,778.28	Facility		$416.87	$891.25	$1,778.28
United Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $602.56 / $1,096.48	Professional		$537.03	$602.56	$1,096.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,174.90 / $1,174.90	Professional		$933.25	$1,174.90	$1,174.90