Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.35 / $2,234.00 / $6,298.62	Facility		$281.35	$2,234.00	$6,298.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $187.21 / $1,182.33 / $3,043.59	Facility	50	$187.21	$1,182.33	$3,043.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.83 / $148.08 / $456.00	Professional		$97.83	$148.08	$456.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $257.39 / $788.04 / $906.00	Professional	50	$257.39	$788.04	$906.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.43 / $291.83 / $377.86	Professional		$204.43	$291.83	$377.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $101.16 / $184.26 / $378.75	Professional		$101.16	$184.26	$378.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $143.90 / $255.50 / $758.10	Facility		$143.90	$255.50	$758.10
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $739.30 / $739.30 / $807.69	Facility	50	$739.30	$739.30	$807.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $133.99 / $263.19 / $784.00	Professional		$133.99	$263.19	$784.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $115.62 / $249.05 / $336.84	Facility		$115.62	$249.05	$336.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $203.73 / $287.22 / $364.28	Professional		$203.73	$287.22	$364.28
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 $127.90 / $194.90 / $366.55	Professional		$127.90	$194.90	$366.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $212.43 / $251.40 / $316.30	Professional		$212.43	$251.40	$316.30