Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.01 / $148.66 / $198.21	Facility		$89.01	$148.66	$198.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.80 / $112.46 / $149.34	Professional		$91.80	$112.46	$149.34
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $128.72 / $128.72 / $128.72	Professional	25	$128.72	$128.72	$128.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.67 / $236.67 / $295.83	Professional		$236.67	$236.67	$295.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $122.75 / $164.66 / $286.87	Professional		$122.75	$164.66	$286.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.07 / $229.64 / $601.01	Facility		$107.07	$229.64	$601.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $177.57 / $290.48	Professional		$120.00	$177.57	$290.48
Midlands Facility/Professional Facility Modifier Low / Median / High Price $192.63 / $239.17 / $265.33	Facility		$192.63	$239.17	$265.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $239.17 / $319.01	Professional		$140.00	$239.17	$319.01
United Facility/Professional Professional Modifier Low / Median / High Price $118.85 / $143.87 / $276.47	Professional		$118.85	$143.87	$276.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $159.69 / $187.90 / $187.90	Professional		$159.69	$187.90	$187.90