Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,000.00 / $1,000.00	Facility		$794.33	$1,000.00	$1,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $562.34 / $954.99	Professional		$407.38	$562.34	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $1,412.54	Facility		$602.56	$602.56	$1,412.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $1,096.48 / $1,412.54	Professional		$602.56	$1,096.48	$1,412.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,174.90 / $1,258.93	Professional		$954.99	$1,174.90	$1,258.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,445.44 / $5,011.87	Facility		$870.96	$1,445.44	$5,011.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $741.31 / $2,137.96	Professional		$588.84	$741.31	$2,137.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,445.44 / $1,659.59	Professional		$1,380.38	$1,445.44	$1,659.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility		$1,412.54	$1,412.54	$1,412.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $2,137.96 / $2,137.96	Professional		$1,096.48	$2,137.96	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $741.31 / $1,548.82	Facility		$467.74	$741.31	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $630.96 / $1,122.02	Professional		$489.78	$630.96	$1,122.02
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,258.93 / $1,258.93	Professional		$977.24	$1,258.93	$1,258.93