Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.09 / $277.95 / $994.05	Facility		$150.09	$277.95	$994.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $300.00	Professional		$79.00	$79.00	$300.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.00 / $153.75 / $153.75	Professional		$123.00	$153.75	$153.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $20.21 / $347.03	Professional		$12.97	$20.21	$347.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $141.41 / $264.47 / $448.99	Facility		$141.41	$264.47	$448.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $195.94 / $221.41 / $236.97	Professional		$195.94	$221.41	$236.97
Midlands Facility/Professional Facility Modifier Low / Median / High Price $376.85 / $462.82 / $637.37	Facility		$376.85	$462.82	$637.37
Midlands Facility/Professional Professional Modifier Low / Median / High Price $371.05 / $371.05 / $371.05	Professional		$371.05	$371.05	$371.05
United Facility/Professional Professional Modifier Low / Median / High Price $195.94 / $221.41 / $231.21	Professional		$195.94	$221.41	$231.21
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $264.47 / $264.47 / $264.47	Facility		$264.47	$264.47	$264.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $264.47 / $264.47 / $264.47	Professional		$264.47	$264.47	$264.47