Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $542.92 / $542.92 / $699.48	Facility		$542.92	$542.92	$699.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $382.79 / $523.79 / $749.77	Professional		$382.79	$523.79	$749.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $568.02 / $568.02 / $695.55	Facility		$568.02	$568.02	$695.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $568.02 / $866.25 / $1,193.65	Professional		$568.02	$866.25	$1,193.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $92.06 / $239.65 / $1,412.24	Professional		$92.06	$239.65	$1,412.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $135.51 / $1,021.27 / $3,720.55	Facility		$135.51	$1,021.27	$3,720.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $462.57 / $600.86 / $1,367.03	Professional		$462.57	$600.86	$1,367.03
Midlands Facility/Professional Facility Modifier Low / Median / High Price $121.90 / $135.51 / $320.29	Facility		$121.90	$135.51	$320.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $121.10 / $150.82 / $320.29	Professional		$121.10	$150.82	$320.29
United Facility/Professional Professional Modifier Low / Median / High Price $463.44 / $527.91 / $1,271.00	Professional		$463.44	$527.91	$1,271.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,108.71 / $1,108.71 / $1,108.71	Facility		$1,108.71	$1,108.71	$1,108.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $875.88 / $1,108.71 / $1,108.71	Professional		$875.88	$1,108.71	$1,108.71