Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $753.66 / $787.28 / $787.28	Facility		$753.66	$787.28	$787.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.93 / $622.15 / $1,008.72	Professional		$467.93	$622.15	$1,008.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $732.96 / $732.96 / $1,167.39	Facility		$732.96	$732.96	$1,167.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,059.67 / $1,313.63 / $1,642.03	Professional		$1,059.67	$1,313.63	$1,642.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $963.10 / $1,240.96 / $1,381.75	Professional		$963.10	$1,240.96	$1,381.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $666.69 / $1,338.38 / $5,476.21	Facility		$666.69	$1,338.38	$5,476.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $507.36 / $583.85 / $1,450.01	Professional		$507.36	$583.85	$1,450.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,163.98 / $1,167.39 / $1,573.64	Facility		$1,163.98	$1,167.39	$1,573.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $956.11 / $1,379.64 / $2,230.88	Professional		$956.11	$1,379.64	$2,230.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,082.49 / $1,159.34 / $2,022.51	Professional		$1,082.49	$1,159.34	$2,022.51
United Facility/Professional Facility Modifier Low / Median / High Price $1,657.40 / $1,657.40 / $2,693.28	Facility		$1,657.40	$1,657.40	$2,693.28
United Facility/Professional Professional Modifier Low / Median / High Price $507.36 / $529.46 / $1,392.03	Professional		$507.36	$529.46	$1,392.03
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,040.03 / $1,040.03 / $1,040.03	Facility		$1,040.03	$1,040.03	$1,040.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $821.62 / $1,040.03 / $1,040.03	Professional		$821.62	$1,040.03	$1,040.03