Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $125.89	Facility		$93.33	$93.33	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $218.78	Professional		$87.10	$102.33	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $416.87 / $436.52	Facility		$407.38	$416.87	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $257.04 / $323.59	Professional		$131.83	$257.04	$323.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $147.91 / $512.86	Professional		$95.50	$147.91	$512.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $269.15 / $1,548.82	Facility		$125.89	$269.15	$1,548.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $199.53 / $1,023.29	Professional		$112.20	$199.53	$1,023.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $251.19 / $295.12	Professional		$177.83	$251.19	$295.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Facility		$436.52	$436.52	$436.52
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $275.42 / $478.63	Professional		$208.93	$275.42	$478.63
United Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $1,445.44 / $1,949.84	Facility		$851.14	$1,445.44	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $269.15	Professional		$112.20	$144.54	$269.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $218.78	Professional		$186.21	$186.21	$218.78