Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $268.76 / $268.76 / $268.76	Facility		$268.76	$268.76	$268.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.95 / $243.20 / $268.76	Professional		$226.95	$243.20	$268.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.75 / $195.75 / $244.69	Professional		$195.75	$195.75	$244.69
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $22.23 / $299.70	Professional		$12.97	$22.23	$299.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.69 / $158.37 / $268.76	Facility		$114.69	$158.37	$268.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $114.69 / $265.73 / $282.19	Professional		$114.69	$265.73	$282.19
Midlands Facility/Professional Facility Modifier Low / Median / High Price $114.69 / $126.37 / $173.68	Facility		$114.69	$126.37	$173.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $80.86 / $126.37 / $167.46	Professional		$80.86	$126.37	$167.46
United Facility/Professional Professional Modifier Low / Median / High Price $235.16 / $265.73 / $282.19	Professional		$235.16	$265.73	$282.19
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $140.66 / $140.66 / $140.66	Facility		$140.66	$140.66	$140.66
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $140.66 / $140.66 / $140.66	Professional		$140.66	$140.66	$140.66