Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.20 / $67.20 / $69.23	Facility		$67.20	$67.20	$69.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.20 / $90.00 / $156.72	Professional		$67.20	$90.00	$156.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.50 / $80.92 / $95.63	Professional		$76.50	$80.92	$95.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $20.21 / $244.74	Professional		$12.97	$20.21	$244.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.20 / $159.34 / $193.07	Facility		$67.20	$159.34	$193.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $82.83 / $130.53 / $194.54	Professional		$82.83	$130.53	$194.54
Midlands Facility/Professional Facility Modifier Low / Median / High Price $136.00 / $173.44 / $239.02	Facility		$136.00	$173.44	$239.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $111.24 / $172.86 / $226.21	Professional		$111.24	$172.86	$226.21
United Facility/Professional Professional Modifier Low / Median / High Price $82.83 / $93.60 / $130.53	Professional		$82.83	$93.60	$130.53
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $82.83 / $82.83 / $82.83	Facility		$82.83	$82.83	$82.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $82.83 / $82.83 / $82.83	Professional		$82.83	$82.83	$82.83