Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $102.33 / $134.90	Facility		$48.98	$102.33	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $100.00	Professional		$51.29	$64.57	$100.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $14.45 / $70.79 / $75.86	Professional	25	$14.45	$70.79	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $169.82	Professional		$134.90	$134.90	$169.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $95.50 / $177.83	Professional		$67.61	$95.50	$177.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $123.03 / $338.84	Facility		$60.26	$123.03	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $95.50 / $147.91	Professional		$67.61	$95.50	$147.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $147.91	Professional		$107.15	$138.04	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $79.43 / $154.88	Professional		$67.61	$79.43	$154.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71