Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility		$1,412.54	$1,412.54	$1,412.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,548.82	Professional		$1,412.54	$1,412.54	$1,548.82
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 $1,412.54 / $1,698.24 / $2,137.96	Professional		$1,412.54	$1,698.24	$2,137.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $2,570.40 / $6,456.54	Professional		$275.42	$2,570.40	$6,456.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,659.59 / $2,398.83	Facility		$1,380.38	$1,659.59	$2,398.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $2,187.76	Professional		$1,380.38	$1,380.38	$2,187.76
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $2,137.96	Professional		$1,659.59	$1,659.59	$2,137.96
Midlands Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $257.04 / $302.00	Facility		$204.17	$257.04	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $1.38 / $1,380.38 / $2,290.87	Facility		$1.38	$1,380.38	$2,290.87
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $1,380.38 / $1,445.44	Professional		$125.89	$1,380.38	$1,445.44
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility		$1,412.54	$1,412.54	$1,412.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Professional		$1,412.54	$1,412.54	$1,412.54