Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $511.20 / $994.48 / $1,391.05	Facility		$511.20	$994.48	$1,391.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $480.53 / $480.53 / $1,381.61	Professional		$480.53	$480.53	$1,381.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $587.29 / $928.28 / $1,160.34	Professional		$587.29	$928.28	$1,160.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $434.52 / $664.56 / $894.60	Professional		$434.52	$664.56	$894.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $613.44 / $664.56 / $2,428.19	Facility		$613.44	$664.56	$2,428.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $306.72 / $306.72 / $1,175.76	Professional		$306.72	$306.72	$1,175.76
Midlands Facility/Professional Facility Modifier Low / Median / High Price $613.44 / $894.60 / $1,120.33	Facility		$613.44	$894.60	$1,120.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $613.44 / $894.60 / $1,120.33	Professional		$613.44	$894.60	$1,120.33
United Facility/Professional Facility Modifier Low / Median / High Price $511.20 / $511.20 / $511.20	Facility		$511.20	$511.20	$511.20
United Facility/Professional Professional Modifier Low / Median / High Price $306.72 / $306.72 / $1,046.68	Professional		$306.72	$306.72	$1,046.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $403.85 / $511.20 / $511.20	Professional		$403.85	$511.20	$511.20