Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $205.92 / $517.20 / $1,750.13	Facility		$205.92	$517.20	$1,750.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.39 / $293.39 / $415.38	Professional		$293.39	$293.39	$415.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.34 / $251.25 / $314.06	Professional		$147.34	$251.25	$314.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,138.40 / $1,397.60 / $1,745.60	Professional		$1,138.40	$1,397.60	$1,745.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $293.39 / $386.72 / $622.51	Facility		$293.39	$386.72	$622.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $329.93 / $366.79 / $476.77	Professional		$329.93	$366.79	$476.77
Midlands Facility/Professional Facility Modifier Low / Median / High Price $376.94 / $386.72 / $386.72	Facility		$376.94	$386.72	$386.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $329.93 / $366.79 / $386.72	Professional		$329.93	$366.79	$386.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $202.08 / $255.80 / $255.80	Professional		$202.08	$255.80	$255.80