Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,200.00 / $1,200.00 / $1,275.00	Professional		$1,200.00	$1,200.00	$1,275.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,200.99 / $1,275.00 / $2,614.51	Professional		$1,200.99	$1,275.00	$2,614.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $1,387.45 / $1,701.82	Professional		$150.00	$1,387.45	$1,701.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $1,500.00 / $2,614.51	Facility		$1,200.00	$1,500.00	$2,614.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,250.00 / $1,250.00 / $2,614.51	Professional		$1,250.00	$1,250.00	$2,614.51
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,227.42 / $1,652.10 / $2,614.51	Facility		$1,227.42	$1,652.10	$2,614.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,200.99 / $1,652.10 / $2,614.51	Professional		$1,200.99	$1,652.10	$2,614.51
United Facility/Professional Professional Modifier Low / Median / High Price $1,250.00 / $1,250.00 / $1,380.00	Professional		$1,250.00	$1,250.00	$1,380.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $790.00 / $1,000.00 / $1,000.00	Professional		$790.00	$1,000.00	$1,000.00