Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.30 / $112.91 / $168.06	Professional		$69.30	$112.91	$168.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.88 / $211.33 / $288.24	Professional		$147.88	$211.33	$288.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $75.20 / $151.57 / $250.25	Professional		$75.20	$151.57	$250.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $111.09 / $196.03 / $661.20	Facility		$111.09	$196.03	$661.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.96 / $203.90 / $720.90	Professional		$111.96	$203.90	$720.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $94.00 / $176.61 / $263.52	Facility		$94.00	$176.61	$263.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $142.88 / $197.30 / $285.06	Professional		$142.88	$197.30	$285.06
United Facility/Professional Facility Modifier Low / Median / High Price $1,151.00 / $1,775.00 / $3,560.25	Facility		$1,151.00	$1,775.00	$3,560.25
United Facility/Professional Professional Modifier Low / Median / High Price $104.85 / $159.78 / $297.58	Professional		$104.85	$159.78	$297.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $148.90 / $175.20 / $249.10	Professional		$148.90	$175.20	$249.10