Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $114.82 / $114.82	Facility		$89.13	$114.82	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $338.84	Professional		$93.33	$120.23	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $114.82	Professional		$93.33	$93.33	$114.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $58.88 / $128.82	Professional		$35.48	$58.88	$128.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $109.65 / $169.82	Facility		$66.07	$109.65	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $114.82	Professional		$74.13	$107.15	$114.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
United Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $109.65 / $117.49	Professional		$95.50	$109.65	$117.49
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50