Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $181.97 / $245.47	Facility		$89.13	$181.97	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $257.04	Professional		$93.33	$120.23	$257.04
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $128.82 / $128.82 / $128.82	Professional	25	$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $302.00	Professional		$239.88	$239.88	$302.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $173.78 / $426.58	Professional		$123.03	$173.78	$426.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $234.42 / $602.56	Facility		$107.15	$234.42	$602.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $263.03	Professional		$117.49	$177.83	$263.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $251.19 / $263.03	Professional		$190.55	$251.19	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $151.36 / $288.40	Professional		$117.49	$151.36	$288.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21