Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $960.00 / $960.00 / $1,020.00	Professional		$960.00	$960.00	$1,020.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.74 / $112.20 / $1,020.00	Professional		$98.74	$112.20	$1,020.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $275.00	Professional		$150.00	$150.00	$275.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $960.00 / $1,200.00 / $1,632.00	Facility		$960.00	$1,200.00	$1,632.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $788.99 / $788.99 / $1,577.98	Professional		$788.99	$788.99	$1,577.98
Midlands Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $788.99 / $788.99 / $867.89	Professional		$788.99	$788.99	$867.89
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $899.99 / $899.99 / $899.99	Facility		$899.99	$899.99	$899.99
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $710.99 / $899.99 / $899.99	Professional		$710.99	$899.99	$899.99