Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $784.44 / $784.44 / $842.70	Facility		$784.44	$784.44	$842.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $464.89 / $617.22 / $1,011.99	Professional		$464.89	$617.22	$1,011.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $700.00 / $1,130.44	Facility		$700.00	$700.00	$1,130.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $700.00 / $1,308.75 / $1,635.94	Professional		$700.00	$1,308.75	$1,635.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $976.29 / $1,201.66 / $1,370.33	Professional		$976.29	$1,201.66	$1,370.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $645.58 / $1,333.55 / $5,530.59	Facility		$645.58	$1,333.55	$5,530.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $491.29 / $583.66 / $1,404.10	Professional		$491.29	$583.66	$1,404.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,127.13 / $1,130.44 / $1,561.18	Facility		$1,127.13	$1,130.44	$1,561.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $987.32 / $1,335.97 / $2,160.25	Professional		$987.32	$1,335.97	$2,160.25
United Facility/Professional Facility Modifier Low / Median / High Price $480.00 / $480.00 / $480.00	Facility		$480.00	$480.00	$480.00
United Facility/Professional Professional Modifier Low / Median / High Price $502.00 / $512.69 / $1,209.16	Professional		$502.00	$512.69	$1,209.16
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,007.12 / $1,007.12 / $1,007.12	Facility		$1,007.12	$1,007.12	$1,007.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $795.62 / $1,007.12 / $1,007.12	Professional		$795.62	$1,007.12	$1,007.12