Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $741.31	Facility		$630.96	$630.96	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $436.52 / $676.08	Professional		$323.59	$436.52	$676.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $891.25	Facility		$575.44	$575.44	$891.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $1,023.29 / $1,288.25	Professional		$575.44	$1,023.29	$1,288.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $891.25 / $1,047.13	Professional		$758.58	$891.25	$1,047.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,023.29 / $3,981.07	Facility		$549.54	$1,023.29	$3,981.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $575.44 / $1,348.96	Professional		$380.19	$575.44	$1,348.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $912.01 / $1,174.90	Professional		$870.96	$912.01	$1,174.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,348.96 / $1,348.96	Professional		$870.96	$1,348.96	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $588.84 / $1,258.93	Facility		$380.19	$588.84	$1,258.93
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $436.52 / $741.31	Professional		$380.19	$436.52	$741.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $794.33 / $794.33	Professional		$616.60	$794.33	$794.33