Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,468.00 / $4,917.20 / $8,042.03	Facility		$3,468.00	$4,917.20	$8,042.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.91 / $656.25 / $656.25	Professional		$53.91	$656.25	$656.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,280.06 / $1,400.36 / $1,600.08	Professional		$1,280.06	$1,400.36	$1,600.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $543.96 / $849.69 / $2,758.90	Professional		$543.96	$849.69	$2,758.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $697.17 / $5,304.92 / $10,320.00	Facility		$697.17	$5,304.92	$10,320.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,039.92 / $1,078.89 / $1,400.36	Professional		$1,039.92	$1,078.89	$1,400.36
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,400.36 / $3,151.30 / $3,929.20	Facility		$1,400.36	$3,151.30	$3,929.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,039.92 / $1,156.08 / $1,400.36	Professional		$1,039.92	$1,156.08	$1,400.36
United Facility/Professional Facility Modifier Low / Median / High Price $5,341.00 / $7,091.00 / $10,320.00	Facility		$5,341.00	$7,091.00	$10,320.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,646.50 / $3,350.00 / $3,350.00	Professional		$2,646.50	$3,350.00	$3,350.00