Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $45.71 / $66.07	Facility		$18.20	$45.71	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $19.95 / $47.86	Professional		$15.14	$19.95	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $45.71 / $57.54	Professional		$28.84	$45.71	$57.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $35.48 / $112.20	Professional		$23.99	$35.48	$112.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $28.84 / $61.66	Facility		$23.99	$28.84	$61.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $23.99 / $52.48	Professional		$11.48	$23.99	$52.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $28.84 / $30.90	Professional		$21.38	$28.84	$30.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $21.38 / $21.38	Facility		$21.38	$21.38	$21.38
United Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $23.99 / $53.70	Facility		$23.99	$23.99	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $14.45 / $52.48	Professional		$11.22	$14.45	$52.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $23.99 / $23.99	Professional		$19.05	$23.99	$23.99