Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.00 / $128.00 / $128.00	Facility		$128.00	$128.00	$128.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.61 / $119.61 / $128.00	Professional		$119.61	$119.61	$128.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.50 / $106.50 / $133.13	Professional		$106.50	$106.50	$133.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $20.21 / $193.60	Professional		$12.97	$20.21	$193.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.00 / $59.97 / $128.00	Facility		$37.00	$59.97	$128.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.14 / $129.01 / $140.74	Professional		$52.14	$129.01	$140.74
Midlands Facility/Professional Facility Modifier Low / Median / High Price $37.00 / $57.16 / $78.08	Facility		$37.00	$57.16	$78.08
Midlands Facility/Professional Professional Modifier Low / Median / High Price $36.45 / $56.79 / $74.81	Professional		$36.45	$56.79	$74.81
United Facility/Professional Professional Modifier Low / Median / High Price $117.28 / $132.53 / $140.74	Professional		$117.28	$132.53	$140.74
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $29.32 / $29.32 / $29.32	Facility		$29.32	$29.32	$29.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $29.32 / $29.32 / $29.32	Professional		$29.32	$29.32	$29.32