Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility		$1,949.84	$1,949.84	$1,949.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,137.96	Professional		$1,949.84	$1,949.84	$2,137.96
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 $147.91 / $181.97 / $1,949.84	Professional		$147.91	$181.97	$1,949.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $724.44 / $1,949.84	Professional		$275.42	$724.44	$1,949.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,344.23 / $3,981.07	Facility		$1,778.28	$2,344.23	$3,981.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $3,090.30	Professional		$1,778.28	$1,778.28	$3,090.30
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $2,137.96	Professional		$616.60	$616.60	$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
Midlands Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $2.24 / $2,238.72 / $4,466.84	Facility		$2.24	$2,238.72	$4,466.84
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $1,949.84 / $2,238.72	Professional		$125.89	$1,949.84	$2,238.72
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility		$1,949.84	$1,949.84	$1,949.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Professional		$1,949.84	$1,949.84	$1,949.84