Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $1,949.84	Facility		$1,513.56	$1,513.56	$1,949.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,318.26 / $1,995.26	Professional		$954.99	$1,318.26	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $2,691.53	Facility		$1,513.56	$1,513.56	$2,691.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,818.38 / $3,548.13	Professional		$1,513.56	$2,818.38	$3,548.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,398.83 / $2,630.27	Professional		$2,089.30	$2,398.83	$2,630.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $3,019.95 / $12,022.64	Facility		$1,621.81	$3,019.95	$12,022.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,513.56 / $3,981.07	Professional		$1,122.02	$1,513.56	$3,981.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,754.23 / $3,467.37	Professional		$2,630.27	$2,754.23	$3,467.37
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Facility		$2,691.53	$2,691.53	$2,691.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $3,981.07 / $3,981.07	Professional		$2,630.27	$3,981.07	$3,981.07
United Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,621.81 / $3,715.35	Facility		$870.96	$1,621.81	$3,715.35
United Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,202.26 / $2,187.76	Professional		$1,122.02	$1,202.26	$2,187.76
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,344.23 / $2,344.23	Professional		$1,862.09	$2,344.23	$2,344.23