Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $697.50 / $697.50 / $853.05	Facility		$697.50	$697.50	$853.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $451.63 / $602.91 / $896.59	Professional		$451.63	$602.91	$896.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $627.26 / $627.26 / $1,208.04	Facility		$627.26	$627.26	$1,208.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $938.82 / $1,173.53 / $1,454.53	Professional		$938.82	$1,173.53	$1,454.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $953.66 / $1,170.43 / $1,268.34	Professional		$953.66	$1,170.43	$1,268.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $689.90 / $1,362.57 / $5,394.87	Facility		$689.90	$1,362.57	$5,394.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $500.81 / $578.79 / $1,460.69	Professional		$500.81	$578.79	$1,460.69
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,204.51 / $1,208.04 / $1,525.01	Facility		$1,204.51	$1,208.04	$1,525.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $999.45 / $1,411.16 / $2,308.53	Professional		$999.45	$1,411.16	$2,308.53
United Facility/Professional Facility Modifier Low / Median / High Price $413.62 / $496.34 / $595.71	Facility		$413.62	$496.34	$595.71
United Facility/Professional Professional Modifier Low / Median / High Price $496.34 / $547.89 / $1,292.15	Professional		$496.34	$547.89	$1,292.15
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,076.26 / $1,076.26 / $1,076.26	Facility		$1,076.26	$1,076.26	$1,076.26
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $850.25 / $1,076.26 / $1,076.26	Professional		$850.25	$1,076.26	$1,076.26