Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,050.14 / $1,050.14 / $2,704.73	Facility		$1,050.14	$1,050.14	$2,704.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $978.91 / $978.91 / $1,050.14	Professional		$978.91	$978.91	$1,050.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $390.00 / $390.00 / $487.50	Professional		$390.00	$390.00	$487.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $269.89 / $412.75 / $977.05	Professional		$269.89	$412.75	$977.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $168.85 / $1,050.14 / $1,080.88	Facility		$168.85	$1,050.14	$1,080.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $247.44 / $1,019.70 / $1,050.29	Professional		$247.44	$1,019.70	$1,050.29
Midlands Facility/Professional Facility Modifier Low / Median / High Price $168.85 / $334.36 / $1,660.64	Facility		$168.85	$334.36	$1,660.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $168.85 / $265.47 / $487.57	Professional		$168.85	$265.47	$487.57
United Facility/Professional Professional Modifier Low / Median / High Price $1,019.70 / $1,019.70 / $1,040.08	Professional		$1,019.70	$1,019.70	$1,040.08
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,019.70 / $1,019.70 / $1,019.70	Facility		$1,019.70	$1,019.70	$1,019.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,019.70 / $1,019.70 / $1,019.70	Professional		$1,019.70	$1,019.70	$1,019.70