Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $897.50 / $897.50 / $897.50	Facility		$897.50	$897.50	$897.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $718.00 / $744.93 / $897.50	Professional		$718.00	$744.93	$897.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $581.44 / $581.44 / $624.63	Facility		$581.44	$581.44	$624.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $677.79 / $1,033.13 / $1,188.99	Professional		$677.79	$1,033.13	$1,188.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $827.41 / $1,014.88	Professional		$150.00	$827.41	$1,014.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $403.32 / $897.50 / $1,220.59	Facility		$403.32	$897.50	$1,220.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,837.70 / $1,997.50 / $3,410.50	Professional		$1,837.70	$1,997.50	$3,410.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $284.83 / $479.00 / $1,240.79	Facility		$284.83	$479.00	$1,240.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $240.06 / $499.78 / $1,240.79	Professional		$240.06	$499.78	$1,240.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $635.29 / $694.50 / $765.60	Professional		$635.29	$694.50	$765.60
United Facility/Professional Professional Modifier Low / Median / High Price $1,997.50 / $1,997.50 / $3,478.45	Professional		$1,997.50	$1,997.50	$3,478.45
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $990.00 / $990.00 / $990.00	Facility		$990.00	$990.00	$990.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $782.10 / $990.00 / $990.00	Professional		$782.10	$990.00	$990.00