Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $691.83	Facility		$436.52	$436.52	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $891.25	Professional		$338.84	$478.63	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $645.65 / $912.01	Facility		$616.60	$645.65	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $812.83 / $933.25	Professional		$645.65	$812.83	$933.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $977.24 / $1,348.96	Professional		$588.84	$977.24	$1,348.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $1,047.13 / $3,019.95	Facility		$446.68	$1,047.13	$3,019.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $616.60 / $1,548.82	Professional		$457.09	$616.60	$1,548.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $954.99 / $1,995.26	Professional		$891.25	$954.99	$1,995.26
Midlands Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $2,884.03	Professional		$1,548.82	$1,548.82	$2,884.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $831.76 / $1,348.96	Professional		$630.96	$831.76	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $630.96 / $1,122.02	Facility		$363.08	$630.96	$1,122.02
United Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $812.83	Professional		$457.09	$457.09	$812.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $794.33 / $794.33	Professional		$616.60	$794.33	$794.33