Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.32 / $143.32 / $143.32	Facility		$143.32	$143.32	$143.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.68 / $214.05 / $468.00	Professional		$108.68	$214.05	$468.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.38 / $114.38 / $142.97	Professional		$114.38	$114.38	$142.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $21.75 / $175.34	Professional		$12.97	$21.75	$175.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $102.08 / $121.11 / $153.77	Facility		$102.08	$121.11	$153.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.05 / $134.99 / $147.21	Professional		$102.05	$134.99	$147.21
Midlands Facility/Professional Facility Modifier Low / Median / High Price $92.56 / $111.02 / $153.77	Facility		$92.56	$111.02	$153.77
Midlands Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $111.02 / $145.29	Professional		$78.00	$111.02	$145.29
United Facility/Professional Professional Modifier Low / Median / High Price $120.06 / $135.66 / $141.66	Professional		$120.06	$135.66	$141.66
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $120.06 / $120.06 / $120.06	Facility		$120.06	$120.06	$120.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.06 / $120.06 / $120.06	Professional		$120.06	$120.06	$120.06