Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.94 / $179.94 / $344.78	Facility		$179.94	$179.94	$344.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.56 / $97.56 / $139.38	Professional		$97.56	$97.56	$139.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.35 / $177.52 / $182.69	Facility		$172.35	$177.52	$182.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.23 / $105.69 / $124.03	Professional		$99.23	$105.69	$124.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $187.50 / $228.00	Professional		$150.00	$187.50	$228.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $91.68 / $128.01 / $177.52	Facility		$91.68	$128.01	$177.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.65 / $100.65 / $120.10	Professional		$100.65	$100.65	$120.10
Midlands Facility/Professional Facility Modifier Low / Median / High Price $120.10 / $177.52 / $182.69	Facility		$120.10	$177.52	$182.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.65 / $120.10 / $120.10	Professional		$100.65	$120.10	$120.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $100.00 / $100.00	Professional		$79.00	$100.00	$100.00