Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $75.86	Facility		$58.88	$58.88	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $93.33	Professional		$58.88	$75.86	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $56.23 / $66.07	Professional		$52.48	$56.23	$66.07
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $22.39 / $151.36	Professional		$14.45	$22.39	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $63.10 / $125.89	Facility		$57.54	$63.10	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $83.18 / $93.33	Professional		$63.10	$83.18	$93.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $95.50	Professional		$74.13	$87.10	$95.50
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13