Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,000.00 / $1,174.90	Facility		$831.76	$1,000.00	$1,174.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $691.83 / $1,023.29	Professional		$489.78	$691.83	$1,023.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $1,445.44	Facility		$933.25	$933.25	$1,445.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,621.81 / $2,041.74	Professional		$933.25	$1,621.81	$2,041.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,380.38 / $1,548.82	Professional		$1,148.15	$1,380.38	$1,548.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,659.59 / $6,025.60	Facility		$870.96	$1,659.59	$6,025.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $870.96 / $2,137.96	Professional		$616.60	$870.96	$2,137.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,479.11 / $1,737.80	Professional		$1,412.54	$1,479.11	$1,737.80
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility		$1,445.44	$1,445.44	$1,445.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $2,137.96 / $2,137.96	Professional		$1,318.26	$2,137.96	$2,137.96
United Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $891.25 / $1,905.46	Facility		$478.63	$891.25	$1,905.46
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $660.69 / $1,174.90	Professional		$588.84	$660.69	$1,174.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,258.93 / $1,258.93	Professional		$1,000.00	$1,258.93	$1,258.93