Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.82 / $76.11 / $135.00	Professional		$39.82	$76.11	$135.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.62 / $165.52 / $259.05	Professional		$91.62	$165.52	$259.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $42.88 / $116.57 / $166.78	Professional		$42.88	$116.57	$166.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.89 / $135.00 / $392.86	Facility		$67.89	$135.00	$392.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.71 / $159.08 / $574.90	Professional		$85.71	$159.08	$574.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $96.80 / $127.40 / $221.71	Facility		$96.80	$127.40	$221.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $96.80 / $141.00 / $224.96	Professional		$96.80	$141.00	$224.96
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 $81.81 / $124.67 / $232.20	Professional		$81.81	$124.67	$232.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.40 / $100.40 / $204.60	Professional		$85.40	$100.40	$204.60