Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $809.93 / $809.93 / $975.01	Facility		$809.93	$809.93	$975.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $387.60 / $743.02 / $1,118.47	Professional		$387.60	$743.02	$1,118.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $795.00 / $795.00 / $1,304.94	Facility		$795.00	$795.00	$1,304.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $795.00 / $1,571.25 / $1,999.16	Professional		$795.00	$1,571.25	$1,999.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $128.56 / $128.56 / $128.56	Professional		$128.56	$128.56	$128.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $98.66 / $1,376.88 / $7,110.09	Facility		$98.66	$1,376.88	$7,110.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $403.70 / $668.58 / $1,831.02	Professional		$403.70	$668.58	$1,831.02
Midlands Facility/Professional Facility Modifier Low / Median / High Price $150.28 / $150.28 / $355.21	Facility		$150.28	$150.28	$355.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $149.12 / $179.59 / $355.21	Professional		$149.12	$179.59	$355.21
United Facility/Professional Professional Modifier Low / Median / High Price $524.80 / $668.58 / $1,831.02	Professional		$524.80	$668.58	$1,831.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $971.37 / $1,229.58 / $1,229.58	Professional		$971.37	$1,229.58	$1,229.58