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 / $741.31 / $912.01	Professional		$660.69	$741.31	$912.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $676.08 / $1,380.38	Professional		$275.42	$676.08	$1,380.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $933.25 / $2,238.72	Facility		$724.44	$933.25	$2,238.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $724.44 / $1,288.25	Professional		$724.44	$724.44	$1,288.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,096.48 / $2,238.72	Professional		$870.96	$1,096.48	$2,238.72
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 $1,202.26 / $1,202.26 / $1,202.26	Professional		$1,202.26	$1,202.26	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $0.72 / $724.44 / $1,174.90	Facility		$0.72	$724.44	$1,174.90
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $724.44 / $1,000.00	Professional		$125.89	$724.44	$1,000.00
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