Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $675.05 / $675.05 / $813.44	Facility		$675.05	$675.05	$813.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $476.87 / $644.09 / $932.21	Professional		$476.87	$644.09	$932.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $670.25 / $670.25 / $1,461.70	Facility		$670.25	$670.25	$1,461.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $670.25 / $1,149.75 / $1,437.19	Professional		$670.25	$1,149.75	$1,437.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.21 / $99.45 / $103.04	Professional		$94.21	$99.45	$103.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $170.07 / $1,681.81 / $4,806.31	Facility		$170.07	$1,681.81	$4,806.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $529.72 / $659.31 / $1,527.60	Professional		$529.72	$659.31	$1,527.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $146.18 / $146.18 / $345.51	Facility		$146.18	$146.18	$345.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $145.16 / $174.77 / $345.51	Professional		$145.16	$174.77	$345.51
United Facility/Professional Professional Modifier Low / Median / High Price $551.47 / $643.38 / $1,527.60	Professional		$551.47	$643.38	$1,527.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $944.79 / $1,195.94 / $1,195.94	Professional		$944.79	$1,195.94	$1,195.94