Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $398.11 / $602.56	Facility		$162.18	$398.11	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $177.83 / $416.87	Professional		$138.04	$177.83	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $398.11 / $501.19	Professional		$251.19	$398.11	$501.19
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $281.84 / $363.08	Professional		$208.93	$281.84	$363.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $251.19 / $537.03	Facility		$194.98	$251.19	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $208.93 / $457.09	Professional		$109.65	$208.93	$457.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $269.15	Professional		$169.82	$251.19	$269.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $467.74	Facility		$208.93	$208.93	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $125.89 / $457.09	Professional		$109.65	$125.89	$457.09
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $208.93 / $208.93	Professional		$165.96	$208.93	$208.93