Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $630.96 / $630.96	Facility		$549.54	$630.96	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $426.58 / $630.96	Professional		$323.59	$426.58	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $912.01	Facility		$489.78	$489.78	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $870.96 / $1,096.48	Professional		$489.78	$870.96	$1,096.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $870.96 / $1,047.13	Professional		$707.95	$870.96	$1,047.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,047.13 / $3,890.45	Facility		$549.54	$1,047.13	$3,890.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $562.34 / $1,348.96	Professional		$380.19	$562.34	$1,348.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $933.25 / $1,148.15	Professional		$891.25	$933.25	$1,148.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $912.01 / $912.01	Facility		$912.01	$912.01	$912.01
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 $371.54 / $575.44 / $1,230.27	Facility		$371.54	$575.44	$1,230.27
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $426.58 / $741.31	Professional		$371.54	$426.58	$741.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $794.33 / $794.33	Professional		$630.96	$794.33	$794.33