Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $346.74	Facility		$302.00	$302.00	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $416.87	Professional		$190.55	$263.03	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $549.54	Facility		$354.81	$354.81	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $575.44 / $724.44	Professional		$354.81	$575.44	$724.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $954.99 / $1,023.29	Professional		$426.58	$954.99	$1,023.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $616.60 / $2,454.71	Facility		$331.13	$616.60	$2,454.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $302.00 / $812.83	Professional		$229.09	$302.00	$812.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $549.54 / $691.83	Professional		$537.03	$549.54	$691.83
Midlands Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $812.83 / $812.83	Professional		$524.81	$812.83	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $309.03 / $758.58	Facility		$177.83	$309.03	$758.58
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $239.88 / $446.68	Professional		$223.87	$239.88	$446.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $457.09 / $457.09	Professional		$363.08	$457.09	$457.09