Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $503.40 / $979.32 / $1,369.85	Facility		$503.40	$979.32	$1,369.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $332.24 / $332.24 / $332.24	Professional		$332.24	$332.24	$332.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $578.20 / $913.92 / $1,142.40	Professional		$578.20	$913.92	$1,142.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $427.89 / $654.41 / $911.15	Professional		$427.89	$654.41	$911.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $503.40 / $649.60 / $1,891.41	Facility		$503.40	$649.60	$1,891.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $302.04 / $302.04 / $1,273.09	Professional		$302.04	$302.04	$1,273.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $604.58 / $920.59 / $1,103.24	Facility		$604.58	$920.59	$1,103.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $604.08 / $990.66 / $1,313.87	Professional		$604.08	$990.66	$1,313.87
United Facility/Professional Facility Modifier Low / Median / High Price $503.40 / $503.40 / $1,157.82	Facility		$503.40	$503.40	$1,157.82
United Facility/Professional Professional Modifier Low / Median / High Price $302.04 / $302.04 / $1,273.09	Professional		$302.04	$302.04	$1,273.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $397.69 / $503.40 / $503.40	Professional		$397.69	$503.40	$503.40