Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.62 / $158.62 / $270.12	Facility		$158.62	$158.62	$270.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.83 / $158.62 / $470.97	Professional		$134.83	$158.62	$470.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.38 / $128.30 / $157.97	Professional		$126.38	$128.30	$157.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $20.21 / $187.70	Professional		$12.97	$20.21	$187.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.19 / $145.80 / $180.63	Facility		$133.19	$145.80	$180.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.28 / $149.65 / $179.63	Professional		$115.28	$149.65	$179.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $106.00 / $136.28 / $187.22	Facility		$106.00	$136.28	$187.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $98.80 / $136.28 / $178.36	Professional		$98.80	$136.28	$178.36
United Facility/Professional Professional Modifier Low / Median / High Price $132.43 / $149.65 / $158.62	Professional		$132.43	$149.65	$158.62
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $132.43 / $132.43 / $132.43	Facility		$132.43	$132.43	$132.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $132.43 / $132.43 / $132.43	Professional		$132.43	$132.43	$132.43