Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.50 / $140.50 / $249.64	Facility		$109.50	$140.50	$249.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.00 / $150.00 / $489.30	Professional		$132.00	$150.00	$489.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.97 / $141.06 / $169.97	Professional		$135.97	$141.06	$169.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $150.00 / $250.36	Professional		$43.00	$150.00	$250.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.45 / $140.50 / $225.56	Facility		$126.45	$140.50	$225.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.08 / $135.81 / $187.82	Professional		$117.08	$135.81	$187.82
Midlands Facility/Professional Facility Modifier Low / Median / High Price $114.21 / $160.16 / $200.21	Facility		$114.21	$160.16	$200.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $153.66 / $207.59	Professional		$78.93	$153.66	$207.59
United Facility/Professional Professional Modifier Low / Median / High Price $117.08 / $132.30 / $140.50	Professional		$117.08	$132.30	$140.50
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $133.47 / $133.47 / $133.47	Facility		$133.47	$133.47	$133.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $133.47 / $133.47 / $133.47	Professional		$133.47	$133.47	$133.47