Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.86 / $99.57 / $117.14	Facility		$87.86	$99.57	$117.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.86 / $108.19 / $130.41	Professional		$87.86	$108.19	$130.41
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $159.88 / $159.88 / $159.88	Professional	25	$159.88	$159.88	$159.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.31 / $225.72 / $282.14	Professional		$109.31	$225.72	$282.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $116.43 / $144.27 / $287.08	Professional		$116.43	$144.27	$287.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $112.92 / $256.76 / $573.72	Facility		$112.92	$256.76	$573.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $130.60 / $198.29 / $288.81	Professional		$130.60	$198.29	$288.81
Midlands Facility/Professional Facility Modifier Low / Median / High Price $183.89 / $233.51 / $253.72	Facility		$183.89	$233.51	$253.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $147.00 / $238.52 / $317.17	Professional		$147.00	$238.52	$317.17
United Facility/Professional Professional Modifier Low / Median / High Price $118.16 / $181.04 / $288.81	Professional		$118.16	$181.04	$288.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.72 / $179.40 / $179.40	Professional		$141.72	$179.40	$179.40