Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $427.88 / $427.88 / $4,336.02	Facility		$427.88	$427.88	$4,336.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.25 / $222.25 / $427.88	Professional		$222.25	$222.25	$427.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.70 / $261.35 / $307.13	Professional		$245.70	$261.35	$307.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $244.48 / $366.71 / $666.66	Professional		$244.48	$366.71	$666.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $237.10 / $289.38 / $427.88	Facility		$237.10	$289.38	$427.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $237.10 / $275.04 / $427.88	Professional		$237.10	$275.04	$427.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $284.52 / $375.79 / $538.25	Facility		$284.52	$375.79	$538.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $284.52 / $289.38 / $342.38	Professional		$284.52	$289.38	$342.38
United Facility/Professional Professional Modifier Low / Median / High Price $222.25 / $251.14 / $427.88	Professional		$222.25	$251.14	$427.88
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $237.10 / $237.10 / $237.10	Facility		$237.10	$237.10	$237.10
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $237.10 / $237.10 / $237.10	Professional		$237.10	$237.10	$237.10