Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $251.19	Facility		$93.33	$93.33	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $275.42	Professional		$87.10	$102.33	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $426.58 / $446.68	Facility		$416.87	$426.58	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $263.03 / $331.13	Professional		$257.04	$263.03	$331.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $177.83 / $512.86	Professional		$107.15	$177.83	$512.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $416.87 / $1,071.52	Facility		$229.09	$416.87	$1,071.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $213.80 / $645.65	Professional		$109.65	$213.80	$645.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $660.69	Professional		$213.80	$257.04	$660.69
Midlands Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $269.15	Professional		$257.04	$257.04	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $912.01 / $1,230.27	Facility		$524.81	$912.01	$1,230.27
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $138.04 / $269.15	Professional		$104.71	$138.04	$269.15
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $218.78	Professional		$147.91	$186.21	$218.78