Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $766.90 / $766.90 / $813.47	Facility		$766.90	$766.90	$813.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $443.35 / $626.78 / $991.13	Professional		$443.35	$626.78	$991.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.27 / $616.27 / $1,208.13	Facility		$616.27	$616.27	$1,208.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.27 / $1,279.50 / $1,599.38	Professional		$616.27	$1,279.50	$1,599.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,048.54 / $1,159.61 / $1,252.93	Professional		$1,048.54	$1,159.61	$1,252.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $722.35 / $1,299.35 / $5,140.93	Facility		$722.35	$1,299.35	$5,140.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $492.02 / $585.26 / $1,500.59	Professional		$492.02	$585.26	$1,500.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,208.13 / $1,208.13 / $1,892.63	Facility		$1,208.13	$1,208.13	$1,892.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,204.59 / $1,427.79 / $2,328.69	Professional		$1,204.59	$1,427.79	$2,328.69
United Facility/Professional Professional Modifier Low / Median / High Price $492.02 / $547.92 / $1,434.85	Professional		$492.02	$547.92	$1,434.85
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,043.39 / $1,043.39 / $1,043.39	Facility		$1,043.39	$1,043.39	$1,043.39
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $824.28 / $1,043.39 / $1,043.39	Professional		$824.28	$1,043.39	$1,043.39