Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $109.65	Facility		$58.88	$58.88	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $75.86 / $114.82	Professional		$39.81	$75.86	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $141.25 / $263.03	Professional		$74.13	$141.25	$263.03
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $66.07 / $288.40	Professional		$35.48	$66.07	$288.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $79.43 / $144.54	Facility		$41.69	$79.43	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $177.83 / $512.86	Professional		$97.72	$177.83	$512.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $213.80	Professional		$97.72	$141.25	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $186.21 / $199.53	Professional		$109.65	$186.21	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $104.71 / $190.55	Professional		$56.23	$104.71	$190.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $141.25	Professional		$63.10	$77.62	$141.25