Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $795.00 / $795.00 / $914.81	Facility		$795.00	$795.00	$914.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $412.09 / $825.68 / $1,097.84	Professional		$412.09	$825.68	$1,097.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $750.60 / $4,321.62 / $6,242.68	Professional		$750.60	$4,321.62	$6,242.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $126.19 / $330.03 / $350.56	Professional		$126.19	$330.03	$350.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $190.27 / $1,224.04 / $4,832.10	Facility		$190.27	$1,224.04	$4,832.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.73 / $112.06 / $2,573.64	Professional		$62.73	$112.06	$2,573.64
Midlands Facility/Professional Facility Modifier Low / Median / High Price $190.65 / $190.65 / $450.63	Facility		$190.65	$190.65	$450.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $189.53 / $228.10 / $450.63	Professional		$189.53	$228.10	$450.63
United Facility/Professional Professional Modifier Low / Median / High Price $62.73 / $64.81 / $779.26	Professional		$62.73	$64.81	$779.26
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,863.19 / $1,863.19 / $1,863.19	Facility		$1,863.19	$1,863.19	$1,863.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,471.92 / $1,863.19 / $1,863.19	Professional		$1,471.92	$1,863.19	$1,863.19