Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.74 / $204.23 / $273.70	Facility		$94.74	$204.23	$273.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.00 / $67.67 / $237.52	Professional		$58.00	$67.67	$237.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.19 / $159.94 / $199.92	Professional		$101.19	$159.94	$199.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $80.18 / $127.43 / $169.88	Professional		$80.18	$127.43	$169.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $87.88 / $113.41 / $231.55	Facility		$87.88	$113.41	$231.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.73 / $87.88 / $202.12	Professional		$52.73	$87.88	$202.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $78.89 / $161.15 / $231.55	Facility		$78.89	$161.15	$231.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.39 / $155.13 / $229.37	Professional		$97.39	$155.13	$229.37
United Facility/Professional Professional Modifier Low / Median / High Price $52.73 / $52.73 / $191.58	Professional		$52.73	$52.73	$191.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $69.43 / $87.88 / $87.88	Professional		$69.43	$87.88	$87.88