Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.84 / $204.84 / $204.84	Facility		$204.84	$204.84	$204.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.64 / $89.64 / $706.46	Professional		$89.64	$89.64	$706.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $388.07 / $399.71 / $411.35	Facility		$388.07	$399.71	$411.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.02 / $243.57 / $304.45	Professional		$222.02	$243.57	$304.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $90.63 / $170.65 / $487.26	Professional		$90.63	$170.65	$487.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $201.39 / $312.20 / $1,031.97	Facility		$201.39	$312.20	$1,031.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.37 / $161.40 / $522.10	Professional		$103.37	$161.40	$522.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $222.02 / $325.14 / $509.39	Facility		$222.02	$325.14	$509.39
Midlands Facility/Professional Professional Modifier Low / Median / High Price $192.80 / $246.00 / $312.20	Professional		$192.80	$246.00	$312.20
United Facility/Professional Professional Modifier Low / Median / High Price $99.55 / $119.46 / $199.10	Professional		$99.55	$119.46	$199.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $140.69 / $178.10 / $209.60	Professional		$140.69	$178.10	$209.60