Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.65 / $418.42 / $577.72	Facility		$225.65	$418.42	$577.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.15 / $161.18 / $565.74	Professional		$138.15	$161.18	$565.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.37 / $379.93 / $474.91	Professional		$240.37	$379.93	$474.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $209.32 / $303.51 / $366.31	Professional		$209.32	$303.51	$366.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $195.50 / $260.89 / $636.67	Facility		$195.50	$260.89	$636.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.63 / $207.16 / $481.44	Professional		$110.63	$207.16	$481.44
Midlands Facility/Professional Facility Modifier Low / Median / High Price $169.26 / $351.25 / $474.32	Facility		$169.26	$351.25	$474.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $209.32 / $332.00 / $474.32	Professional		$209.32	$332.00	$474.32
United Facility/Professional Professional Modifier Low / Median / High Price $112.14 / $125.59 / $481.44	Professional		$112.14	$125.59	$481.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $165.36 / $209.32 / $209.32	Professional		$165.36	$209.32	$209.32