Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $100.00 / $128.82	Facility		$87.10	$100.00	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $144.54	Professional		$85.11	$107.15	$144.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	25	$158.49	$158.49	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $229.09 / $288.40	Professional		$109.65	$229.09	$288.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $204.17 / $288.40	Professional		$117.49	$204.17	$288.40
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $269.15 / $575.44	Facility		$114.82	$269.15	$575.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $190.55 / $251.19	Professional		$117.49	$190.55	$251.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $234.42 / $251.19	Professional		$181.97	$234.42	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $181.97 / $288.40	Professional		$117.49	$181.97	$288.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $177.83 / $177.83	Professional		$141.25	$177.83	$177.83