Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.00 / $164.00 / $164.00	Professional		$164.00	$164.00	$164.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.11 / $26.11 / $26.11	Facility		$26.11	$26.11	$26.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.52 / $26.11 / $32.64	Professional		$16.52	$26.11	$32.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.90 / $56.52 / $112.04	Facility		$23.90	$56.52	$112.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.63 / $21.76 / $37.14	Professional		$12.63	$21.76	$37.14
Midlands Facility/Professional Facility Modifier Low / Median / High Price $35.17 / $40.27 / $44.10	Facility		$35.17	$40.27	$44.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $35.17 / $40.27 / $62.85	Professional		$35.17	$40.27	$62.85
United Facility/Professional Professional Modifier Low / Median / High Price $10.07 / $14.51 / $37.14	Professional		$10.07	$14.51	$37.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $25.10 / $25.10 / $25.10	Professional		$25.10	$25.10	$25.10