Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $739.37 / $739.37 / $919.14	Facility		$739.37	$739.37	$919.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.28 / $683.27 / $1,530.00	Professional		$407.28	$683.27	$1,530.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $1,279.55	Facility		$812.83	$812.83	$1,279.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,021.13 / $1,279.55	Professional		$812.83	$1,021.13	$1,279.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $762.72 / $1,296.96 / $1,673.69	Professional		$762.72	$1,296.96	$1,673.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $647.60 / $1,512.20 / $3,899.19	Facility		$647.60	$1,512.20	$3,899.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $630.26 / $741.59 / $1,951.05	Professional		$630.26	$741.59	$1,951.05
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,279.55 / $1,381.02 / $1,744.54	Facility		$1,279.55	$1,381.02	$1,744.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,279.55 / $1,530.12 / $2,690.96	Professional		$1,279.55	$1,530.12	$2,690.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $783.31 / $904.66 / $1,572.37	Professional		$783.31	$904.66	$1,572.37
United Facility/Professional Professional Modifier Low / Median / High Price $624.64 / $712.41 / $1,598.60	Professional		$624.64	$712.41	$1,598.60
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,139.97 / $1,139.97 / $1,139.97	Facility		$1,139.97	$1,139.97	$1,139.97
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $900.58 / $1,139.97 / $1,139.97	Professional		$900.58	$1,139.97	$1,139.97