Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $403.84 / $403.84 / $403.84	Facility		$403.84	$403.84	$403.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $356.95 / $356.95 / $3,101.39	Professional		$356.95	$356.95	$3,101.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,318.61 / $1,358.17 / $1,397.73	Facility		$1,318.61	$1,358.17	$1,397.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $846.82 / $939.37 / $1,174.22	Professional		$846.82	$939.37	$1,174.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $340.64 / $532.01 / $1,191.80	Professional		$340.64	$532.01	$1,191.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $552.60 / $1,036.45 / $3,352.67	Facility		$552.60	$1,036.45	$3,352.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $364.40 / $547.65 / $1,218.55	Professional		$364.40	$547.65	$1,218.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $846.82 / $1,161.42 / $1,674.85	Facility		$846.82	$1,161.42	$1,674.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $495.85 / $867.19 / $1,161.42	Professional		$495.85	$867.19	$1,161.42
United Facility/Professional Professional Modifier Low / Median / High Price $382.78 / $483.64 / $868.73	Professional		$382.78	$483.64	$868.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $536.73 / $679.40 / $799.30	Professional		$536.73	$679.40	$799.30