Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,557.09 / $1,557.09 / $1,557.09	Facility		$1,557.09	$1,557.09	$1,557.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,557.09 / $1,557.09 / $3,814.25	Professional		$1,557.09	$1,557.09	$3,814.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $686.97 / $686.97 / $686.97	Professional		$686.97	$686.97	$686.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $19,241.75 / $21,806.02 / $23,097.94	Professional		$19,241.75	$21,806.02	$23,097.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,557.09 / $5,450.12	Facility		$100.00	$1,557.09	$5,450.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $780.65 / $780.65 / $780.65	Professional		$780.65	$780.65	$780.65
Midlands Facility/Professional Facility Modifier Low / Median / High Price $780.65 / $780.65 / $780.65	Facility		$780.65	$780.65	$780.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $780.65 / $780.65 / $780.65	Professional		$780.65	$780.65	$780.65
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $650.00 / $650.00	Facility		$650.00	$650.00	$650.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $513.50 / $650.00 / $650.00	Professional		$513.50	$650.00	$650.00