Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.95 / $199.95 / $300.27	Facility		$199.95	$199.95	$300.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.33 / $189.60 / $514.00	Professional		$151.33	$189.60	$514.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.88 / $156.93 / $186.09	Professional		$148.88	$156.93	$186.09
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $22.23 / $241.31	Professional		$12.97	$22.23	$241.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $140.93 / $216.59 / $480.00	Facility		$140.93	$216.59	$480.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.93 / $188.43 / $312.60	Professional		$140.93	$188.43	$312.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $121.83 / $184.46 / $596.51	Facility		$121.83	$184.46	$596.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.78 / $161.93 / $480.00	Professional		$107.78	$161.93	$480.00
United Facility/Professional Professional Modifier Low / Median / High Price $166.75 / $188.43 / $199.95	Professional		$166.75	$188.43	$199.95
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $166.75 / $166.75 / $166.75	Facility		$166.75	$166.75	$166.75
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $166.75 / $166.75 / $166.75	Professional		$166.75	$166.75	$166.75