Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.95 / $575.95 / $693.35	Facility		$575.95	$575.95	$693.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.85 / $521.07 / $782.22	Professional		$300.85	$521.07	$782.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $458.33 / $458.33 / $915.12	Facility		$458.33	$458.33	$915.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $458.32 / $1,117.50 / $1,460.31	Professional		$458.32	$1,117.50	$1,460.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.42 / $91.42 / $91.42	Professional		$91.42	$91.42	$91.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $106.95 / $1,309.19 / $4,986.09	Facility		$106.95	$1,309.19	$4,986.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $470.76 / $643.64 / $1,302.07	Professional		$470.76	$643.64	$1,302.07
Midlands Facility/Professional Facility Modifier Low / Median / High Price $103.91 / $106.95 / $252.80	Facility		$103.91	$106.95	$252.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $103.61 / $124.54 / $252.80	Professional		$103.61	$124.54	$252.80
United Facility/Professional Professional Modifier Low / Median / High Price $474.36 / $549.22 / $1,302.07	Professional		$474.36	$549.22	$1,302.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $691.31 / $875.07 / $875.07	Professional		$691.31	$875.07	$875.07