Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.93 / $105.63 / $155.04	Professional		$61.93	$105.63	$155.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.51 / $188.93 / $287.29	Professional		$125.51	$188.93	$287.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.14 / $140.09 / $251.58	Professional		$67.14	$140.09	$251.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.83 / $181.39 / $661.20	Facility		$103.83	$181.39	$661.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.34 / $189.64 / $705.65	Professional		$101.34	$189.64	$705.65
Midlands Facility/Professional Facility Modifier Low / Median / High Price $90.22 / $167.00 / $249.86	Facility		$90.22	$167.00	$249.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.49 / $184.87 / $262.27	Professional		$134.49	$184.87	$262.27
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 $96.66 / $147.30 / $274.33	Professional		$96.66	$147.30	$274.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $132.80 / $156.30 / $231.00	Professional		$132.80	$156.30	$231.00