Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.97 / $225.80 / $343.08	Facility		$102.97	$225.80	$343.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.04 / $73.55 / $258.16	Professional		$63.04	$73.55	$258.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.86 / $173.64 / $217.06	Professional		$109.86	$173.64	$217.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $95.52 / $143.28 / $204.61	Professional		$95.52	$143.28	$204.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $95.52 / $124.18 / $387.83	Facility		$95.52	$124.18	$387.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $95.52 / $232.58	Professional		$57.31	$95.52	$232.58
Midlands Facility/Professional Facility Modifier Low / Median / High Price $98.88 / $175.14 / $231.21	Facility		$98.88	$175.14	$231.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.62 / $175.14 / $243.58	Professional		$114.62	$175.14	$243.58
United Facility/Professional Facility Modifier Low / Median / High Price $95.52 / $95.52 / $95.52	Facility		$95.52	$95.52	$95.52
United Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $66.59 / $225.53	Professional		$57.31	$66.59	$225.53
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.45 / $95.52 / $95.52	Professional		$75.45	$95.52	$95.52