Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.18 / $112.40 / $154.50	Facility		$99.18	$112.40	$154.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.18 / $149.44 / $186.34	Professional		$99.18	$149.44	$186.34
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $152.11 / $152.11 / $152.11	Professional	25	$152.11	$152.11	$152.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.27 / $252.49 / $315.61	Professional		$122.27	$252.49	$315.61
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $130.63 / $203.07 / $361.46	Professional		$130.63	$203.07	$361.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $127.86 / $354.11 / $685.02	Facility		$127.86	$354.11	$685.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $184.89 / $274.25 / $408.88	Professional		$184.89	$274.25	$408.88
Midlands Facility/Professional Facility Modifier Low / Median / High Price $205.25 / $274.25 / $347.56	Facility		$205.25	$274.25	$347.56
Midlands Facility/Professional Professional Modifier Low / Median / High Price $217.00 / $284.64 / $449.03	Professional		$217.00	$284.64	$449.03
United Facility/Professional Facility Modifier Low / Median / High Price $160.47 / $160.47 / $160.47	Facility		$160.47	$160.47	$160.47
United Facility/Professional Professional Modifier Low / Median / High Price $167.29 / $223.46 / $408.88	Professional		$167.29	$223.46	$408.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $158.16 / $200.20 / $200.20	Professional		$158.16	$200.20	$200.20