Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,411.90 / $2,521.09 / $2,521.09	Facility		$2,411.90	$2,521.09	$2,521.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,140.84 / $1,644.85 / $2,521.09	Professional		$1,140.84	$1,644.85	$2,521.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,711.28 / $1,711.28 / $4,016.71	Facility		$1,711.28	$1,711.28	$4,016.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,711.28 / $3,489.38 / $4,361.72	Professional		$1,711.28	$3,489.38	$4,361.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,829.00 / $3,206.01 / $3,651.55	Professional		$2,829.00	$3,206.01	$3,651.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,328.65 / $4,381.85 / $14,301.99	Facility		$2,328.65	$4,381.85	$14,301.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,625.19 / $2,049.44 / $4,785.66	Professional		$1,625.19	$2,049.44	$4,785.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $4,004.95 / $4,016.71 / $4,814.06	Facility		$4,004.95	$4,016.71	$4,814.06
Midlands Facility/Professional Professional Modifier Low / Median / High Price $3,143.76 / $4,325.67 / $7,675.84	Professional		$3,143.76	$4,325.67	$7,675.84
United Facility/Professional Professional Modifier Low / Median / High Price $1,579.06 / $1,821.72 / $3,912.88	Professional		$1,579.06	$1,821.72	$3,912.88
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $3,578.52 / $3,578.52 / $3,578.52	Facility		$3,578.52	$3,578.52	$3,578.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,827.03 / $3,578.52 / $3,578.52	Professional		$2,827.03	$3,578.52	$3,578.52