Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $954.99	Facility		$812.83	$812.83	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $691.83 / $1,148.15	Professional		$549.54	$691.83	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $1,445.44	Facility		$724.44	$724.44	$1,445.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,513.56 / $1,862.09	Professional		$724.44	$1,513.56	$1,862.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,548.82 / $1,698.24	Professional		$1,230.27	$1,548.82	$1,698.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,548.82 / $6,025.60	Facility		$851.14	$1,548.82	$6,025.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $831.76 / $2,137.96	Professional		$588.84	$831.76	$2,137.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,659.59 / $3,235.94	Professional		$1,412.54	$1,659.59	$3,235.94
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility		$1,445.44	$1,445.44	$1,445.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,137.96 / $2,137.96	Professional		$1,318.26	$2,137.96	$2,137.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,698.24 / $2,818.38	Professional		$1,318.26	$1,698.24	$2,818.38
United Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $954.99 / $1,905.46	Facility		$446.68	$954.99	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $645.65 / $1,122.02	Professional		$575.44	$645.65	$1,122.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,230.27 / $1,230.27	Professional		$977.24	$1,230.27	$1,230.27