Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $249.00 / $249.00 / $249.00	Professional		$249.00	$249.00	$249.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.70 / $45.70 / $45.70	Facility		$45.70	$45.70	$45.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $45.70 / $57.12	Professional		$28.91	$45.70	$57.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.25 / $47.88 / $112.04	Facility		$20.25	$47.88	$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 / $28.73	Professional		$10.07	$14.51	$28.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $25.10 / $25.10 / $25.10	Professional		$25.10	$25.10	$25.10