Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $74.13	Facility		$72.44	$72.44	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $186.21	Professional		$72.44	$72.44	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $181.97	Professional		$144.54	$144.54	$181.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $134.90 / $173.78	Professional		$81.28	$134.90	$173.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $89.13 / $125.89	Facility		$77.62	$89.13	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $83.18 / $100.00	Professional		$74.13	$83.18	$100.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $95.50 / $95.50	Professional		$89.13	$95.50	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $83.18 / $87.10	Professional		$74.13	$83.18	$87.10
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13