Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $138.04 / $741.31	Facility		$123.03	$138.04	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $245.47 / $346.74	Professional		$123.03	$245.47	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $151.36 / $158.49	Facility		$147.91	$151.36	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $102.33 / $123.03	Professional		$91.20	$102.33	$123.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $194.98 / $234.42	Professional		$186.21	$194.98	$234.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $295.12 / $467.74	Facility		$109.65	$295.12	$467.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $102.33 / $102.33	Professional		$87.10	$102.33	$102.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Midlands Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Facility		$158.49	$158.49	$158.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $389.05 / $524.81	Facility		$223.87	$389.05	$524.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11