Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $85.31 / $159.90	Professional		$32.10	$85.31	$159.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.97 / $155.19 / $266.83	Professional		$74.97	$155.19	$266.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $31.97 / $108.94 / $354.51	Professional		$31.97	$108.94	$354.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.77 / $150.63 / $770.22	Facility		$64.77	$150.63	$770.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $93.47 / $199.51 / $402.06	Professional		$93.47	$199.51	$402.06
Midlands Facility/Professional Facility Modifier Low / Median / High Price $74.97 / $129.38 / $267.89	Facility		$74.97	$129.38	$267.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $74.97 / $198.47 / $269.20	Professional		$74.97	$198.47	$269.20
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 $94.54 / $172.65 / $293.11	Professional		$94.54	$172.65	$293.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $66.09 / $138.88 / $206.90	Professional		$66.09	$138.88	$206.90