Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $309.03	Facility		$123.03	$123.03	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $123.03	Professional		$64.57	$85.11	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $165.96 / $186.21	Professional		$147.91	$165.96	$186.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $234.42	Professional		$70.79	$134.90	$234.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $218.78 / $1,445.44	Facility		$162.18	$218.78	$1,445.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $181.97 / $562.34	Professional		$95.50	$181.97	$562.34
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $316.23	Professional		$165.96	$165.96	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Professional		$165.96	$165.96	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,380.38 / $1,819.70	Facility		$794.33	$1,380.38	$1,819.70
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $288.40	Professional		$93.33	$120.23	$288.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $112.20 / $131.83	Professional		$89.13	$112.20	$131.83