Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $794.33	Professional		$660.69	$660.69	$794.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $245.47 / $302.00	Facility		$190.55	$245.47	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,047.13 / $1,318.26	Professional		$660.69	$1,047.13	$1,318.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $645.65 / $831.76	Professional		$275.42	$645.65	$831.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,230.27 / $1,905.46	Facility		$851.14	$1,230.27	$1,905.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,096.48 / $1,659.59	Professional		$1,023.29	$1,096.48	$1,659.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $1,230.27 / $1,584.89	Professional		$199.53	$1,230.27	$1,584.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $257.04 / $302.00	Facility		$204.17	$257.04	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $1.02 / $1,023.29 / $1,698.24	Facility		$1.02	$1,023.29	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $1,023.29 / $1,659.59	Professional		$125.89	$1,023.29	$1,659.59
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Professional		$660.69	$660.69	$660.69