Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $502.50 / $502.50 / $691.92	Facility		$502.50	$502.50	$691.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $333.66 / $447.09 / $759.94	Professional		$333.66	$447.09	$759.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $621.29 / $647.80 / $881.60	Facility		$621.29	$647.80	$881.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $713.63 / $881.60 / $910.95	Professional		$713.63	$881.60	$910.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $593.61 / $961.93 / $1,350.86	Professional		$593.61	$961.93	$1,350.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $440.42 / $1,041.89 / $3,006.95	Facility		$440.42	$1,041.89	$3,006.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $440.21 / $550.27 / $1,258.11	Professional		$440.21	$550.27	$1,258.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $881.60 / $917.11 / $1,206.89	Facility		$881.60	$917.11	$1,206.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $881.60 / $1,053.97 / $1,865.34	Professional		$881.60	$1,053.97	$1,865.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $624.85 / $669.21 / $1,128.34	Professional		$624.85	$669.21	$1,128.34
United Facility/Professional Professional Modifier Low / Median / High Price $440.21 / $474.70 / $1,099.38	Professional		$440.21	$474.70	$1,099.38
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $785.42 / $785.42 / $785.42	Facility		$785.42	$785.42	$785.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $620.48 / $785.42 / $785.42	Professional		$620.48	$785.42	$785.42