Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $57.54 / $223.87	Facility		$19.95	$57.54	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $22.91 / $39.81	Professional		$19.05	$22.91	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $50.12 / $64.57	Facility		$36.31	$50.12	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.11 / $48.98	Professional		$26.92	$33.11	$48.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $40.74 / $57.54	Professional		$27.54	$40.74	$57.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $37.15 / $144.54	Facility		$20.42	$37.15	$144.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $37.15 / $117.49	Professional		$23.44	$37.15	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $47.86 / $54.95	Professional		$38.90	$47.86	$54.95
Midlands Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $54.95	Professional		$33.88	$33.88	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $33.88 / $48.98	Facility		$30.90	$33.88	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $30.20 / $50.12	Professional		$23.44	$30.20	$50.12
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $46.77	Professional		$39.81	$39.81	$46.77