Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $891.25 / $891.25	Facility		$724.44	$891.25	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $758.58 / $891.25	Professional		$724.44	$758.58	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $630.96	Facility		$575.44	$575.44	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $831.76 / $1,023.29	Professional		$758.58	$831.76	$1,023.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $831.76 / $1,047.13	Professional		$275.42	$831.76	$1,047.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $891.25 / $1,258.93	Facility		$478.63	$891.25	$1,258.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,995.26 / $3,388.44	Professional		$1,202.26	$1,995.26	$3,388.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $1,202.26 / $1,230.27	Professional		$478.63	$1,202.26	$1,230.27
Midlands Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $630.96 / $676.08	Facility		$575.44	$630.96	$676.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $1,202.26	Professional		$426.58	$426.58	$1,202.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $758.58 / $831.76	Professional		$691.83	$758.58	$831.76
United Facility/Professional Facility Modifier Low / Median / High Price $2.00 / $1,995.26 / $3,311.31	Facility		$2.00	$1,995.26	$3,311.31
United Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $2,041.74	Professional		$1,995.26	$1,995.26	$2,041.74
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Professional		$1,000.00	$1,000.00	$1,000.00