Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.75 / $133.94 / $206.09	Facility		$103.75	$133.94	$206.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.50 / $93.59 / $387.00	Professional		$70.50	$93.59	$387.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $65.00 / $176.02	Facility		$50.00	$65.00	$176.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.21 / $233.80 / $292.25	Professional		$170.21	$233.80	$292.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $103.02 / $134.51 / $253.95	Professional		$103.02	$134.51	$253.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.50 / $159.78 / $293.05	Facility		$70.50	$159.78	$293.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $106.91 / $181.08 / $293.05	Professional		$106.91	$181.08	$293.05
Midlands Facility/Professional Facility Modifier Low / Median / High Price $176.02 / $196.91 / $277.91	Facility		$176.02	$196.91	$277.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.62 / $196.91 / $277.91	Professional		$138.62	$196.91	$277.91
United Facility/Professional Facility Modifier Low / Median / High Price $119.55 / $119.55 / $169.54	Facility		$119.55	$119.55	$169.54
United Facility/Professional Professional Modifier Low / Median / High Price $98.34 / $149.31 / $236.61	Professional		$98.34	$149.31	$236.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $190.60 / $190.60 / $224.30	Professional		$190.60	$190.60	$224.30