Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $670.00 / $2,912.34 / $7,119.04	Facility		$670.00	$2,912.34	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.67 / $160.22 / $521.37	Professional		$95.67	$160.22	$521.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.44 / $276.60 / $453.83	Professional		$215.44	$276.60	$453.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $106.35 / $194.14 / $653.72	Professional		$106.35	$194.14	$653.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $159.80 / $266.85 / $1,778.52	Facility		$159.80	$266.85	$1,778.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $175.05 / $320.89 / $740.00	Professional		$175.05	$320.89	$740.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $215.44 / $346.43 / $699.52	Facility		$215.44	$346.43	$699.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $215.44 / $305.56 / $447.17	Professional		$215.44	$305.56	$447.17
United Facility/Professional Facility Modifier Low / Median / High Price $1,775.00 / $3,482.00 / $5,454.00	Facility		$1,775.00	$3,482.00	$5,454.00
United Facility/Professional Professional Modifier Low / Median / High Price $163.56 / $249.23 / $507.08	Professional		$163.56	$249.23	$507.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $190.00 / $241.35 / $359.40	Professional		$190.00	$241.35	$359.40