Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Facility		$45.00	$45.00	$45.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $379.93 / $379.93 / $379.93	Facility		$379.93	$379.93	$379.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $379.93 / $379.93 / $2,428.77	Professional		$379.93	$379.93	$2,428.77
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Professional		$150.00	$150.00	$150.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $90.00 / $2,787.50	Facility		$45.00	$90.00	$2,787.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,341.04 / $2,787.50 / $2,787.50	Professional		$2,341.04	$2,787.50	$2,787.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,787.50 / $2,787.50 / $2,787.50	Facility		$2,787.50	$2,787.50	$2,787.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,428.77 / $2,428.77 / $2,787.50	Professional		$2,428.77	$2,428.77	$2,787.50
United Facility/Professional Professional Modifier Low / Median / High Price $2,757.30 / $2,757.30 / $2,757.30	Professional		$2,757.30	$2,757.30	$2,757.30
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $2,321.00 / $2,321.00 / $2,321.00	Facility		$2,321.00	$2,321.00	$2,321.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,833.59 / $2,321.00 / $2,321.00	Professional		$1,833.59	$2,321.00	$2,321.00