Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,047.13 / $1,148.15	Professional		$912.01	$1,047.13	$1,148.15
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 $309.03 / $380.19 / $1,047.13	Professional		$309.03	$380.19	$1,047.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $309.03 / $1,047.13	Professional		$162.18	$309.03	$1,047.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $870.96 / $1,348.96	Facility		$302.00	$870.96	$1,348.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $870.96 / $1,202.26	Professional		$363.08	$870.96	$1,202.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $363.08 / $1,047.13	Professional		$269.15	$363.08	$1,047.13
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 $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $0.30 / $302.00 / $489.78	Facility		$0.30	$302.00	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $302.00 / $1,000.00	Professional		$125.89	$302.00	$1,000.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13