Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $405.00 / $405.00 / $428.74	Facility		$405.00	$405.00	$428.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.13 / $326.02 / $523.42	Professional		$234.13	$326.02	$523.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $325.37 / $325.37 / $638.03	Facility		$325.37	$325.37	$638.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $638.03 / $675.75 / $844.69	Professional		$638.03	$675.75	$844.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $466.30 / $582.88 / $1,999.28	Professional		$466.30	$582.88	$1,999.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $364.38 / $667.85 / $2,714.31	Facility		$364.38	$667.85	$2,714.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $259.77 / $303.07 / $792.50	Professional		$259.77	$303.07	$792.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $638.03 / $638.03 / $791.03	Facility		$638.03	$638.03	$791.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $636.17 / $754.04 / $1,219.29	Professional		$636.17	$754.04	$1,219.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $582.88 / $624.26 / $1,056.06	Professional		$582.88	$624.26	$1,056.06
United Facility/Professional Professional Modifier Low / Median / High Price $277.30 / $289.37 / $690.42	Professional		$277.30	$289.37	$690.42
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $551.03 / $551.03 / $551.03	Facility		$551.03	$551.03	$551.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $435.31 / $551.03 / $551.03	Professional		$435.31	$551.03	$551.03