Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.67 / $94.67 / $109.87	Facility		$94.67	$94.67	$109.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.88 / $78.03 / $109.87	Professional		$64.88	$78.03	$109.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.60 / $159.59 / $200.65	Professional		$100.60	$159.59	$200.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.25 / $96.48 / $139.72	Professional		$63.25	$96.48	$139.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.23 / $156.84 / $248.54	Facility		$72.23	$156.84	$248.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $103.69 / $163.43 / $434.29	Professional		$103.69	$163.43	$434.29
Midlands Facility/Professional Facility Modifier Low / Median / High Price $140.04 / $168.38 / $194.68	Facility		$140.04	$168.38	$194.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $124.97 / $162.77 / $204.56	Professional		$124.97	$162.77	$204.56
United Facility/Professional Professional Modifier Low / Median / High Price $89.11 / $141.40 / $220.35	Professional		$89.11	$141.40	$220.35
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $115.20 / $132.80 / $138.10	Professional		$115.20	$132.80	$138.10