Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $619.52 / $619.52 / $911.58	Facility		$619.52	$619.52	$911.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $357.38 / $559.16 / $854.41	Professional		$357.38	$559.16	$854.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $758.68 / $758.68 / $1,104.04	Facility		$758.68	$758.68	$1,104.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.68 / $882.75 / $1,104.04	Professional		$758.68	$882.75	$1,104.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $659.19 / $1,041.40 / $1,128.52	Professional		$659.19	$1,041.40	$1,128.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $559.16 / $1,299.66 / $3,377.04	Facility		$559.16	$1,299.66	$3,377.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $551.38 / $648.77 / $1,681.67	Professional		$551.38	$648.77	$1,681.67
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,104.04 / $1,191.66 / $1,505.34	Facility		$1,104.04	$1,191.66	$1,505.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,104.04 / $1,320.22 / $2,322.06	Professional		$1,104.04	$1,320.22	$2,322.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $676.99 / $781.86 / $1,358.92	Professional		$676.99	$781.86	$1,358.92
United Facility/Professional Professional Modifier Low / Median / High Price $588.41 / $614.04 / $1,233.06	Professional		$588.41	$614.04	$1,233.06
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $983.60 / $983.60 / $983.60	Facility		$983.60	$983.60	$983.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $777.04 / $983.60 / $983.60	Professional		$777.04	$983.60	$983.60