Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.20 / $166.02 / $195.31	Facility		$79.20	$166.02	$195.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.76 / $90.60 / $122.41	Professional		$74.76	$90.60	$122.41
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $175.00 / $175.00 / $175.00	Professional	25	$175.00	$175.00	$175.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.80 / $231.80 / $289.75	Professional		$231.80	$231.80	$289.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.32 / $135.78 / $279.56	Professional		$120.32	$135.78	$279.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $104.91 / $195.86 / $588.88	Facility		$104.91	$195.86	$588.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $131.96 / $247.30	Professional		$96.60	$131.96	$247.30
Midlands Facility/Professional Facility Modifier Low / Median / High Price $158.71 / $192.75 / $260.83	Facility		$158.71	$192.75	$260.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $110.52 / $188.75 / $260.83	Professional		$110.52	$188.75	$260.83
United Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $122.02 / $224.71	Professional		$93.11	$122.02	$224.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $156.50 / $184.10 / $184.10	Professional		$156.50	$184.10	$184.10