Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $65.26 / $100.78	Professional		$41.00	$65.26	$100.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.93 / $124.63 / $186.98	Professional		$86.93	$124.63	$186.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.75 / $90.10 / $154.27	Professional		$43.75	$90.10	$154.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.23 / $117.00 / $392.86	Facility		$67.23	$117.00	$392.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.94 / $124.63 / $483.65	Professional		$66.94	$124.63	$483.65
Midlands Facility/Professional Facility Modifier Low / Median / High Price $59.43 / $115.78 / $165.03	Facility		$59.43	$115.78	$165.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.44 / $124.63 / $167.56	Professional		$91.44	$124.63	$167.56
United Facility/Professional Facility Modifier Low / Median / High Price $207.18 / $474.26 / $1,966.00	Facility		$207.18	$474.26	$1,966.00
United Facility/Professional Professional Modifier Low / Median / High Price $61.12 / $93.14 / $176.51	Professional		$61.12	$93.14	$176.51
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $101.20 / $149.50	Professional		$86.00	$101.20	$149.50