Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $2,511.89 / $6,760.83	Facility		$1,047.13	$2,511.89	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $812.83 / $1,778.28	Professional		$575.44	$812.83	$1,778.28
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,290.87 / $2,290.87 / $2,398.83	Professional	50	$2,290.87	$2,290.87	$2,398.83
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Professional	54	$1,288.25	$1,288.25	$1,288.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $1,412.54 / $1,949.84	Professional		$645.65	$1,412.54	$1,949.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $831.76 / $1,513.56	Professional		$501.19	$831.76	$1,513.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,659.59 / $4,677.35	Facility		$891.25	$1,659.59	$4,677.35
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility	54	$1,905.46	$1,905.46	$1,905.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,479.11 / $4,466.84	Professional		$776.25	$1,479.11	$4,466.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,513.56 / $1,862.09	Professional		$1,288.25	$1,513.56	$1,862.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional		$1,348.96	$1,348.96	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,388.44 / $6,309.57	Facility		$1,819.70	$3,388.44	$6,309.57
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $912.01 / $1,862.09	Professional		$630.96	$912.01	$1,862.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,288.25 / $1,513.56	Professional		$1,023.29	$1,288.25	$1,513.56