Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.04 / $170.04 / $170.04	Facility		$170.04	$170.04	$170.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.24 / $72.28 / $194.02	Professional		$44.24	$72.28	$194.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.34 / $124.66 / $228.86	Professional		$78.34	$124.66	$228.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.83 / $99.06 / $171.86	Professional		$44.83	$99.06	$171.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.73 / $122.50 / $1,341.00	Facility		$68.73	$122.50	$1,341.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.48 / $122.50 / $336.08	Professional		$82.48	$122.50	$336.08
Midlands Facility/Professional Facility Modifier Low / Median / High Price $103.05 / $137.65 / $202.88	Facility		$103.05	$137.65	$202.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.95 / $136.13 / $202.88	Professional		$97.95	$136.13	$202.88
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,623.00 / $2,126.00	Facility		$1,204.00	$1,623.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $79.70 / $103.97 / $185.13	Professional		$79.70	$103.97	$185.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $95.60 / $168.80	Professional		$81.20	$95.60	$168.80