Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $691.83	Facility		$575.44	$575.44	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $501.19 / $794.33	Professional		$346.74	$501.19	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $1,174.90	Facility		$575.44	$575.44	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,047.13 / $1,288.25	Professional		$575.44	$1,047.13	$1,288.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $89.13 / $91.20	Professional		$72.44	$89.13	$91.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $1,380.38 / $4,168.69	Facility		$114.82	$1,380.38	$4,168.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $489.78 / $1,202.26	Professional		$371.54	$489.78	$1,202.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,348.96 / $2,691.53	Professional		$1,148.15	$1,348.96	$2,691.53
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
United Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $354.81 / $724.44	Facility		$41.69	$354.81	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $478.63 / $1,288.25	Professional		$436.52	$478.63	$1,288.25
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $933.25 / $933.25	Professional		$741.31	$933.25	$933.25