Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $81.28	Facility		$75.86	$75.86	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $77.62 / $134.90	Professional		$64.57	$77.62	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $223.87 / $229.09	Facility		$213.80	$223.87	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $199.53 / $251.19	Professional		$87.10	$199.53	$251.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $107.15 / $275.42	Professional		$70.79	$107.15	$275.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $177.83 / $446.68	Facility		$81.28	$177.83	$446.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $125.89 / $575.44	Professional		$67.61	$125.89	$575.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $169.82 / $218.78	Professional		$102.33	$169.82	$218.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $141.25 / $218.78	Professional		$134.90	$141.25	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $407.38 / $537.03	Facility		$245.47	$407.38	$537.03
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $169.82	Professional		$64.57	$93.33	$169.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $169.82	Professional		$141.25	$141.25	$169.82