Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $662.58 / $1,288.99 / $1,803.01	Facility		$662.58	$1,288.99	$1,803.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $437.30 / $510.19 / $510.19	Professional		$437.30	$510.19	$510.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $795.10 / $795.10 / $795.10	Facility		$795.10	$795.10	$795.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $795.10 / $1,203.10 / $1,503.89	Professional		$795.10	$1,203.10	$1,503.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $728.84 / $828.23 / $1,199.27	Professional		$728.84	$828.23	$1,199.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $662.58 / $861.35 / $3,147.26	Facility		$662.58	$861.35	$3,147.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $397.55 / $397.55 / $1,675.66	Professional		$397.55	$397.55	$1,675.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $795.10 / $861.35 / $1,822.38	Facility		$795.10	$861.35	$1,822.38
Midlands Facility/Professional Professional Modifier Low / Median / High Price $795.10 / $1,364.91 / $1,822.38	Professional		$795.10	$1,364.91	$1,822.38
United Facility/Professional Professional Modifier Low / Median / High Price $397.55 / $397.55 / $1,444.42	Professional		$397.55	$397.55	$1,444.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $523.44 / $662.58 / $662.58	Professional		$523.44	$662.58	$662.58