Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $374.90 / $467.01	Professional		$40.00	$374.90	$467.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.84 / $102.74 / $126.56	Professional		$98.84	$102.74	$126.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $90.58 / $106.56 / $122.96	Professional		$90.58	$106.56	$122.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.31 / $118.11 / $633.58	Facility		$74.31	$118.11	$633.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.25 / $66.33 / $129.21	Professional		$45.25	$66.33	$129.21
Midlands Facility/Professional Facility Modifier Low / Median / High Price $98.84 / $112.44 / $682.40	Facility		$98.84	$112.44	$682.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.58 / $112.44 / $682.40	Professional		$93.58	$112.44	$682.40
United Facility/Professional Professional Modifier Low / Median / High Price $45.25 / $63.25 / $123.43	Professional		$45.25	$63.25	$123.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $101.83 / $128.90 / $128.90	Professional		$101.83	$128.90	$128.90