Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,906.00 / $4,235.59 / $7,119.04	Facility		$2,906.00	$4,235.59	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.55 / $86.17 / $206.30	Professional		$42.55	$86.17	$206.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.70 / $200.14 / $264.89	Professional		$99.70	$200.14	$264.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.56 / $110.76 / $369.32	Professional		$42.56	$110.76	$369.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.92 / $158.29 / $770.22	Facility		$84.92	$158.29	$770.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.50 / $209.87 / $423.38	Professional		$103.50	$209.87	$423.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.63 / $140.78 / $279.55	Facility		$95.63	$140.78	$279.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $99.70 / $200.14 / $280.91	Professional		$99.70	$200.14	$280.91
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,640.00 / $2,126.00	Facility		$1,204.00	$1,640.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $103.01 / $193.83 / $318.54	Professional		$103.01	$193.83	$318.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $87.90 / $139.44 / $207.60	Professional		$87.90	$139.44	$207.60