Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $3,388.44	Facility		$2,884.03	$2,884.03	$3,388.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,995.26 / $2,884.03	Professional		$1,412.54	$1,995.26	$2,884.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $4,073.80	Facility		$2,630.27	$2,630.27	$4,073.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $4,677.35 / $5,888.44	Professional		$2,630.27	$4,677.35	$5,888.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $3,311.31 / $4,073.80 / $4,570.88	Professional		$3,311.31	$4,073.80	$4,570.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $4,677.35 / $17,378.01	Facility		$2,511.89	$4,677.35	$17,378.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,511.89 / $6,165.95	Professional		$1,737.80	$2,511.89	$6,165.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $3,981.07 / $4,168.69 / $5,011.87	Professional		$3,981.07	$4,168.69	$5,011.87
Midlands Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,073.80	Facility		$4,073.80	$4,073.80	$4,073.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $6,165.95 / $6,165.95	Professional		$3,801.89	$6,165.95	$6,165.95
United Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $2,570.40 / $5,370.32	Facility		$1,621.81	$2,570.40	$5,370.32
United Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,905.46 / $3,388.44	Professional		$1,698.24	$1,905.46	$3,388.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,818.38 / $3,548.13 / $3,548.13	Professional		$2,818.38	$3,548.13	$3,548.13