Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $2,238.72 / $6,456.54	Facility		$128.82	$2,238.72	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $141.25 / $478.63	Professional		$66.07	$141.25	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $194.98 / $269.15	Professional		$125.89	$194.98	$269.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $120.23 / $269.15	Professional		$67.61	$120.23	$269.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $173.78 / $1,380.38	Facility		$97.72	$173.78	$1,380.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $181.97 / $512.86	Professional		$91.20	$181.97	$512.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $204.17 / $251.19	Professional		$162.18	$204.17	$251.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $338.84	Professional		$181.97	$181.97	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,621.81 / $3,548.13	Facility		$1,148.15	$1,621.81	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $120.23 / $234.42	Professional		$72.44	$120.23	$234.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $158.49 / $213.80	Professional		$134.90	$158.49	$213.80