Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $819.96 / $4,014.00 / $6,446.00	Facility		$819.96	$4,014.00	$6,446.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,612.83 / $9,612.83 / $9,612.83	Facility	50	$9,612.83	$9,612.83	$9,612.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $377.02 / $687.17 / $1,723.06	Professional		$377.02	$687.17	$1,723.06
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $516.03 / $952.85 / $2,735.34	Professional	50	$516.03	$952.85	$2,735.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $661.57 / $1,342.63 / $2,073.38	Professional		$661.57	$1,342.63	$2,073.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $286.80 / $947.47 / $2,333.54	Professional		$286.80	$947.47	$2,333.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $483.35 / $1,703.95 / $9,822.68	Facility		$483.35	$1,703.95	$9,822.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $747.79 / $1,611.54 / $8,263.84	Professional		$747.79	$1,611.54	$8,263.84
Midlands Facility/Professional Facility Modifier Low / Median / High Price $708.23 / $1,798.57 / $9,822.68	Facility		$708.23	$1,798.57	$9,822.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $661.57 / $1,514.00 / $2,118.33	Professional		$661.57	$1,514.00	$2,118.33
United Facility/Professional Facility Modifier Low / Median / High Price $8,220.00 / $9,259.00 / $14,242.22	Facility		$8,220.00	$9,259.00	$14,242.22
United Facility/Professional Professional Modifier Low / Median / High Price $741.24 / $1,320.11 / $2,298.05	Professional		$741.24	$1,320.11	$2,298.05
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $583.40 / $686.30 / $1,616.50	Professional		$583.40	$686.30	$1,616.50