Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $212.00 / $212.00	Facility		$212.00	$212.00	$212.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.20 / $198.21 / $212.00	Professional		$180.20	$198.21	$212.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.13 / $166.00 / $196.41	Professional		$157.13	$166.00	$196.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $22.23 / $208.88	Professional		$12.97	$22.23	$208.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $171.61 / $207.92 / $246.73	Facility		$171.61	$207.92	$246.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $170.38 / $199.64 / $243.80	Professional		$170.38	$199.64	$243.80
Midlands Facility/Professional Facility Modifier Low / Median / High Price $154.41 / $194.09 / $255.74	Facility		$154.41	$194.09	$255.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $191.70 / $263.19	Professional		$138.04	$191.70	$263.19
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $205.63 / $218.36	Professional		$181.97	$205.63	$218.36
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $176.67 / $176.67 / $176.67	Facility		$176.67	$176.67	$176.67
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $176.67 / $176.67 / $176.67	Professional		$176.67	$176.67	$176.67