Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.93 / $59.68 / $115.96	Facility		$29.93	$59.68	$115.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.67 / $19.44 / $162.36	Professional		$16.67	$19.44	$162.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $45.70 / $57.12	Professional		$28.91	$45.70	$57.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $25.25 / $44.19 / $123.35	Professional		$25.25	$44.19	$123.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.25 / $42.34 / $120.30	Facility		$25.25	$42.34	$120.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $15.15 / $26.01 / $68.72	Professional		$15.15	$26.01	$68.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $30.92 / $51.46 / $79.16	Facility		$30.92	$51.46	$79.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $30.33 / $51.46 / $68.72	Professional		$30.33	$51.46	$68.72
United Facility/Professional Facility Modifier Low / Median / High Price $25.25 / $25.25 / $25.25	Facility		$25.25	$25.25	$25.25
United Facility/Professional Professional Modifier Low / Median / High Price $15.15 / $21.17 / $58.08	Professional		$15.15	$21.17	$58.08
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.25 / $25.25	Professional		$19.95	$25.25	$25.25