Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,230.27 / $1,318.26	Facility		$1,174.90	$1,230.27	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $812.83 / $1,348.96	Professional		$676.08	$812.83	$1,348.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $1,778.28	Facility		$891.25	$891.25	$1,778.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,862.09 / $2,290.87	Professional		$891.25	$1,862.09	$2,290.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,698.24 / $2,041.74	Professional		$1,513.56	$1,698.24	$2,041.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $2,041.74 / $7,413.10	Facility		$1,071.52	$2,041.74	$7,413.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,071.52 / $2,630.27	Professional		$758.58	$1,071.52	$2,630.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,819.70 / $2,137.96	Professional		$1,737.80	$1,819.70	$2,137.96
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Facility		$1,778.28	$1,778.28	$1,778.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,630.27 / $2,630.27	Professional		$1,621.81	$2,630.27	$2,630.27
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,174.90 / $2,290.87	Facility		$707.95	$1,174.90	$2,290.87
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $812.83 / $1,445.44	Professional		$724.44	$812.83	$1,445.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,548.82 / $1,548.82	Professional		$1,230.27	$1,548.82	$1,548.82