Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $530.75 / $530.75 / $795.17	Facility		$530.75	$530.75	$795.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.75 / $479.02 / $773.72	Professional		$349.75	$479.02	$773.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $636.97 / $636.97 / $984.92	Facility		$636.97	$636.97	$984.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $636.97 / $763.91 / $984.92	Professional		$636.97	$763.91	$984.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $622.24 / $1,039.38 / $1,143.42	Professional		$622.24	$1,039.38	$1,143.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $467.98 / $1,163.99 / $3,153.85	Facility		$467.98	$1,163.99	$3,153.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $481.81 / $577.12 / $1,469.84	Professional		$481.81	$577.12	$1,469.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $984.92 / $1,064.46 / $1,344.67	Facility		$984.92	$1,064.46	$1,344.67
Midlands Facility/Professional Professional Modifier Low / Median / High Price $984.92 / $1,177.69 / $2,075.52	Professional		$984.92	$1,177.69	$2,075.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $654.99 / $701.49 / $1,182.78	Professional		$654.99	$701.49	$1,182.78
United Facility/Professional Professional Modifier Low / Median / High Price $481.81 / $536.70 / $921.34	Professional		$481.81	$536.70	$921.34
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $877.47 / $877.47 / $877.47	Facility		$877.47	$877.47	$877.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $693.20 / $877.47 / $877.47	Professional		$693.20	$877.47	$877.47