Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $44.49 / $68.45	Professional		$27.63	$44.49	$68.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.66 / $78.88 / $127.58	Professional		$58.66	$78.88	$127.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.08 / $58.07 / $101.46	Professional		$28.08	$58.07	$101.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.05 / $89.59 / $392.86	Facility		$44.05	$89.59	$392.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.56 / $87.84 / $327.68	Professional		$49.56	$87.84	$327.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $37.27 / $73.59 / $115.78	Facility		$37.27	$73.59	$115.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $59.76 / $87.45 / $115.78	Professional		$59.76	$87.45	$115.78
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $1,640.00 / $2,126.00	Facility		$1,204.00	$1,640.00	$2,126.00
United Facility/Professional Professional Modifier Low / Median / High Price $42.17 / $71.42 / $134.44	Professional		$42.17	$71.42	$134.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $53.30 / $62.70 / $99.70	Professional		$53.30	$62.70	$99.70