Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.60 / $549.60 / $575.48	Facility		$549.60	$549.60	$575.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $325.52 / $475.06 / $845.09	Professional		$325.52	$475.06	$845.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $494.25 / $494.25 / $1,015.59	Facility		$494.25	$494.25	$1,015.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $494.25 / $916.88 / $1,146.08	Professional		$494.25	$916.88	$1,146.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $751.43 / $923.26 / $990.90	Professional		$751.43	$923.26	$990.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $579.99 / $1,063.10 / $4,154.25	Facility		$579.99	$1,063.10	$4,154.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $394.61 / $469.40 / $1,211.00	Professional		$394.61	$469.40	$1,211.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,012.62 / $1,015.59 / $1,217.19	Facility		$1,012.62	$1,015.59	$1,217.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $818.08 / $1,186.33 / $1,940.75	Professional		$818.08	$1,186.33	$1,940.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $806.80 / $941.73 / $1,648.02	Professional		$806.80	$941.73	$1,648.02
United Facility/Professional Professional Modifier Low / Median / High Price $391.09 / $460.60 / $1,028.27	Professional		$391.09	$460.60	$1,028.27
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $877.10 / $877.10 / $877.10	Facility		$877.10	$877.10	$877.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $692.91 / $877.10 / $877.10	Professional		$692.91	$877.10	$877.10