Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $181.97	Facility		$66.07	$66.07	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $72.44 / $239.88	Professional		$61.66	$72.44	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $309.03 / $316.23	Facility		$302.00	$309.03	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $223.87 / $281.84	Professional		$190.55	$223.87	$281.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $151.36 / $380.19	Professional		$81.28	$151.36	$380.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $346.74 / $1,445.44	Facility		$173.78	$346.74	$1,445.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $147.91 / $446.68	Professional		$77.62	$147.91	$446.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $457.09	Professional		$147.91	$190.55	$457.09
Midlands Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $223.87 / $223.87	Professional		$190.55	$223.87	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,258.93 / $1,698.24	Facility		$707.95	$1,258.93	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $95.50 / $208.93	Professional		$74.13	$95.50	$208.93
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $190.55	Professional		$128.82	$162.18	$190.55