Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $879.52 / $1,043.94 / $1,043.94	Facility		$879.52	$1,043.94	$1,043.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $497.52 / $772.23 / $1,123.35	Professional		$497.52	$772.23	$1,123.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $755.39 / $755.39 / $1,689.60	Facility		$755.39	$755.39	$1,689.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $755.39 / $1,741.88 / $2,177.34	Professional		$755.39	$1,741.88	$2,177.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,257.76 / $1,423.11 / $1,536.00	Professional		$1,257.76	$1,423.11	$1,536.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $964.91 / $1,774.70 / $6,411.18	Facility		$964.91	$1,774.70	$6,411.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $603.10 / $766.30 / $2,014.72	Professional		$603.10	$766.30	$2,014.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,684.66 / $1,689.60 / $2,025.00	Facility		$1,684.66	$1,689.60	$2,025.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,361.04 / $1,836.49 / $3,228.81	Professional		$1,361.04	$1,836.49	$3,228.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,532.49 / $1,641.30 / $2,741.76	Professional		$1,532.49	$1,641.30	$2,741.76
United Facility/Professional Professional Modifier Low / Median / High Price $597.73 / $766.30 / $1,807.24	Professional		$597.73	$766.30	$1,807.24
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,505.28 / $1,505.28 / $1,505.28	Facility		$1,505.28	$1,505.28	$1,505.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,189.17 / $1,505.28 / $1,505.28	Professional		$1,189.17	$1,505.28	$1,505.28