Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $501.19 / $1,148.15	Facility		$218.78	$501.19	$1,148.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $389.05 / $812.83	Professional		$251.19	$389.05	$812.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $691.83	Facility		$467.74	$467.74	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $562.34 / $707.95	Professional		$467.74	$562.34	$707.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $851.14 / $870.96	Professional		$467.74	$851.14	$870.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $794.33 / $2,398.83	Facility		$346.74	$794.33	$2,398.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $457.09 / $1,148.15	Professional		$331.13	$457.09	$1,148.15
Midlands Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $724.44 / $1,513.56	Professional		$676.08	$724.44	$1,513.56
Midlands Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Professional		$1,148.15	$1,148.15	$1,148.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $660.69 / $1,071.52	Professional		$501.19	$660.69	$1,071.52
United Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $501.19 / $1,318.26	Facility		$269.15	$501.19	$1,318.26
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $602.56	Professional		$338.84	$338.84	$602.56
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $602.56 / $602.56	Professional		$478.63	$602.56	$602.56