Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $1,989.59	Professional		$1,969.89	$1,969.89	$1,989.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $539.01 / $612.51 / $1,969.89	Professional		$539.01	$612.51	$1,969.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $377.47 / $1,969.89 / $3,565.50	Professional		$377.47	$1,969.89	$3,565.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,789.55 / $2,701.20 / $3,042.24	Facility		$1,789.55	$2,701.20	$3,042.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,789.55 / $1,789.55 / $3,579.10	Professional		$1,789.55	$1,789.55	$3,579.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $612.51 / $2,147.44 / $2,147.44	Facility		$612.51	$2,147.44	$2,147.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $612.51 / $612.51 / $2,147.44	Professional		$612.51	$612.51	$2,147.44
United Facility/Professional Facility Modifier Low / Median / High Price $2.25 / $2.25 / $2.25	Facility		$2.25	$2.25	$2.25
United Facility/Professional Professional Modifier Low / Median / High Price $1,969.89 / $1,969.89 / $2,089.86	Professional		$1,969.89	$1,969.89	$2,089.86
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,789.55 / $1,789.55 / $1,789.55	Facility		$1,789.55	$1,789.55	$1,789.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,413.74 / $1,789.55 / $1,789.55	Professional		$1,413.74	$1,789.55	$1,789.55