Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $724.44	Facility		$616.60	$616.60	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $524.81 / $870.96	Professional		$407.38	$524.81	$870.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $1,096.48	Facility		$549.54	$549.54	$1,096.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $1,148.15 / $1,445.44	Professional		$549.54	$1,148.15	$1,445.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $977.24 / $1,047.13	Professional		$831.76	$977.24	$1,047.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,174.90 / $4,570.88	Facility		$676.08	$1,174.90	$4,570.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $602.56 / $1,659.59	Professional		$436.52	$602.56	$1,659.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,122.02 / $1,348.96	Professional		$1,071.52	$1,122.02	$1,348.96
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility		$1,096.48	$1,096.48	$1,096.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,659.59 / $1,659.59	Professional		$1,023.29	$1,659.59	$1,659.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,318.26 / $2,137.96	Professional		$1,000.00	$1,318.26	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $741.31 / $1,445.44	Facility		$338.84	$741.31	$1,445.44
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $489.78 / $891.25	Professional		$436.52	$489.78	$891.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $933.25 / $933.25	Professional		$741.31	$933.25	$933.25