Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $627.87 / $753.83 / $753.83	Facility		$627.87	$753.83	$753.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $359.50 / $518.32 / $753.83	Professional		$359.50	$518.32	$753.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $582.20 / $582.20 / $975.39	Facility		$582.20	$582.20	$975.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $582.20 / $1,043.25 / $1,304.06	Professional		$582.20	$1,043.25	$1,304.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $854.99 / $1,036.85 / $1,308.15	Professional		$854.99	$1,036.85	$1,308.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $565.48 / $1,152.74 / $4,473.42	Facility		$565.48	$1,152.74	$4,473.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $430.54 / $574.05 / $1,211.53	Professional		$430.54	$574.05	$1,211.53
Midlands Facility/Professional Facility Modifier Low / Median / High Price $972.54 / $975.39 / $1,311.03	Facility		$972.54	$975.39	$1,311.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $798.86 / $1,139.40 / $1,863.98	Professional		$798.86	$1,139.40	$1,863.98
United Facility/Professional Facility Modifier Low / Median / High Price $500.36 / $500.36 / $500.36	Facility		$500.36	$500.36	$500.36
United Facility/Professional Professional Modifier Low / Median / High Price $430.54 / $503.62 / $1,162.13	Professional		$430.54	$503.62	$1,162.13
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $868.99 / $868.99 / $868.99	Facility		$868.99	$868.99	$868.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $686.50 / $868.99 / $868.99	Professional		$686.50	$868.99	$868.99