Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $962.00 / $962.00 / $962.00	Facility		$962.00	$962.00	$962.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.28 / $175.28 / $175.28	Professional		$175.28	$175.28	$175.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.50 / $140.25 / $175.31	Professional		$122.50	$140.25	$175.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $445.39 / $546.80 / $682.96	Professional		$445.39	$546.80	$682.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $130.58 / $175.28 / $323.00	Facility		$130.58	$175.28	$323.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.13 / $115.76 / $122.50	Professional		$104.13	$115.76	$122.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $118.97 / $122.50 / $122.50	Facility		$118.97	$122.50	$122.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.13 / $115.76 / $122.50	Professional		$104.13	$115.76	$122.50
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $99.36 / $125.77 / $125.77	Professional		$99.36	$125.77	$125.77