Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $112.20 / $169.82	Facility		$44.67	$112.20	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $47.86 / $72.44	Professional		$39.81	$47.86	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $112.20 / $141.25	Professional		$75.86	$112.20	$141.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $107.15 / $208.93	Professional		$58.88	$107.15	$208.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $75.86 / $154.88	Facility		$58.88	$75.86	$154.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $70.79 / $239.88	Professional		$35.48	$70.79	$239.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $75.86	Professional		$70.79	$70.79	$75.86
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $134.90	Facility		$58.88	$58.88	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $147.91	Professional		$35.48	$35.48	$147.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88