Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $891.25	Facility		$660.69	$660.69	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $562.34 / $933.25	Professional		$446.68	$562.34	$933.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $1,174.90	Facility		$741.31	$741.31	$1,174.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,230.27 / $1,513.56	Professional		$741.31	$1,230.27	$1,513.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,148.15 / $1,230.27	Professional		$891.25	$1,148.15	$1,230.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,348.96 / $5,623.41	Facility		$707.95	$1,348.96	$5,623.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $676.08 / $1,737.80	Professional		$501.19	$676.08	$1,737.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,202.26 / $1,584.89	Professional		$1,148.15	$1,202.26	$1,584.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility		$1,174.90	$1,174.90	$1,174.90
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,737.80 / $1,737.80	Professional		$1,202.26	$1,737.80	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $870.96 / $1,698.24	Facility		$398.11	$870.96	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $524.81 / $954.99	Professional		$501.19	$524.81	$954.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,023.29 / $1,023.29	Professional		$812.83	$1,023.29	$1,023.29