Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $251.19 / $331.13	Facility		$123.03	$251.19	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $162.18 / $363.08	Professional		$123.03	$162.18	$363.08
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $229.09 / $588.84 / $588.84	Professional	25	$229.09	$588.84	$588.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $407.38	Professional		$331.13	$331.13	$407.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $223.87 / $549.54	Professional		$165.96	$223.87	$549.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $302.00 / $812.83	Facility		$144.54	$302.00	$812.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $229.09 / $354.81	Professional		$151.36	$229.09	$354.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $338.84 / $363.08	Professional		$263.03	$338.84	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $190.55 / $371.54	Professional		$144.54	$190.55	$371.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04