Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $338.84 / $489.78	Facility		$134.90	$338.84	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $151.36 / $251.19	Professional		$117.49	$151.36	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $338.84 / $426.58	Professional		$257.04	$338.84	$426.58
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $309.03 / $588.84	Professional		$151.36	$309.03	$588.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $213.80 / $478.63	Facility		$173.78	$213.80	$478.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $177.83 / $389.05	Professional		$107.15	$177.83	$389.05
Midlands Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $229.09	Professional		$213.80	$213.80	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $389.05	Facility		$177.83	$177.83	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $389.05	Professional		$107.15	$107.15	$389.05
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $177.83	Professional		$141.25	$177.83	$177.83