Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.79 / $291.01 / $291.01	Professional		$199.79	$291.01	$291.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $501.20 / $534.59 / $668.24	Professional		$501.20	$534.59	$668.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.29 / $232.50 / $398.99	Professional		$150.29	$232.50	$398.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $365.78 / $462.91 / $543.90	Facility		$365.78	$462.91	$543.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $463.29 / $1,044.03	Professional		$302.00	$463.29	$1,044.03
Midlands Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $457.56 / $522.44	Facility		$302.00	$457.56	$522.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $424.87 / $532.88	Professional		$302.00	$424.87	$532.88
United Facility/Professional Professional Modifier Low / Median / High Price $259.11 / $491.29 / $644.19	Professional		$259.11	$491.29	$644.19
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $273.58 / $346.30 / $407.40	Professional		$273.58	$346.30	$407.40