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 $642.98 / $990.11 / $1,002.85	Professional		$642.98	$990.11	$1,002.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,428.09 / $1,580.28 / $1,785.11	Professional		$1,428.09	$1,580.28	$1,785.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $606.87 / $975.21 / $1,638.30	Professional		$606.87	$975.21	$1,638.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,023.00 / $1,812.55 / $14,428.30	Facility		$1,023.00	$1,812.55	$14,428.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $733.28 / $1,452.31 / $2,280.39	Professional		$733.28	$1,452.31	$2,280.39
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,023.00 / $1,899.53 / $5,661.05	Facility		$1,023.00	$1,899.53	$5,661.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $950.55 / $1,448.33 / $1,899.53	Professional		$950.55	$1,448.33	$1,899.53
United Facility/Professional Facility Modifier Low / Median / High Price $8,220.00 / $9,346.00 / $14,242.22	Facility		$8,220.00	$9,346.00	$14,242.22
United Facility/Professional Professional Modifier Low / Median / High Price $702.73 / $1,258.80 / $1,989.22	Professional		$702.73	$1,258.80	$1,989.22
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,048.96 / $1,327.80 / $1,562.10	Professional		$1,048.96	$1,327.80	$1,562.10