Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,218.00 / $3,576.15 / $7,119.04	Facility		$2,218.00	$3,576.15	$7,119.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.06 / $219.78 / $1,034.00	Professional		$70.06	$219.78	$1,034.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.88 / $222.65 / $528.80	Professional		$105.88	$222.65	$528.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $64.89 / $178.89 / $380.02	Professional		$64.89	$178.89	$380.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $163.87 / $399.80 / $1,371.00	Facility		$163.87	$399.80	$1,371.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $179.55 / $343.04 / $686.06	Professional		$179.55	$343.04	$686.06
Midlands Facility/Professional Facility Modifier Low / Median / High Price $163.87 / $258.64 / $451.28	Facility		$163.87	$258.64	$451.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $148.47 / $335.40 / $498.41	Professional		$148.47	$335.40	$498.41
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,623.00 / $2,126.00	Facility		$1,204.00	$1,623.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $178.46 / $271.94 / $523.26	Professional		$178.46	$271.94	$523.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $128.60 / $151.30 / $401.30	Professional		$128.60	$151.30	$401.30