Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $350.00 / $350.00 / $350.00	Facility		$350.00	$350.00	$350.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $350.00 / $350.00 / $350.00	Professional		$350.00	$350.00	$350.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $626.86 / $720.59 / $854.31	Professional		$626.86	$720.59	$854.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $774.35 / $796.39 / $851.87	Professional		$774.35	$796.39	$851.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $350.00 / $514.79 / $768.04	Facility		$350.00	$514.79	$768.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $604.22 / $720.59 / $2,757.30	Professional		$604.22	$720.59	$2,757.30
Midlands Facility/Professional Facility Modifier Low / Median / High Price $720.59 / $720.59 / $720.59	Facility		$720.59	$720.59	$720.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $626.86 / $626.86 / $720.59	Professional		$626.86	$626.86	$720.59
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 $600.00 / $600.00 / $600.00	Facility		$600.00	$600.00	$600.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $474.00 / $600.00 / $600.00	Professional		$474.00	$600.00	$600.00