Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,477.41 / $1,491.12 / $1,491.12	Facility		$1,477.41	$1,491.12	$1,491.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $642.15 / $925.83 / $1,491.12	Professional		$642.15	$925.83	$1,491.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $963.22 / $963.22 / $2,221.23	Facility		$963.22	$963.22	$2,221.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $963.22 / $2,064.00 / $2,580.00	Professional		$963.22	$2,064.00	$2,580.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,691.22 / $1,922.01 / $2,099.42	Professional		$1,691.22	$1,922.01	$2,099.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,287.75 / $2,466.40 / $8,261.60	Facility		$1,287.75	$2,466.40	$8,261.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $914.77 / $1,146.85 / $2,646.47	Professional		$914.77	$1,146.85	$2,646.47
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,214.73 / $2,221.23 / $2,662.17	Facility		$2,214.73	$2,221.23	$2,662.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,769.52 / $2,392.09 / $4,244.74	Professional		$1,769.52	$2,392.09	$4,244.74
United Facility/Professional Professional Modifier Low / Median / High Price $888.80 / $1,016.24 / $2,314.30	Professional		$888.80	$1,016.24	$2,314.30
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,978.92 / $1,978.92 / $1,978.92	Facility		$1,978.92	$1,978.92	$1,978.92
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,563.35 / $1,978.92 / $1,978.92	Professional		$1,563.35	$1,978.92	$1,978.92