Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $81.28 / $123.03	Facility		$47.86	$81.28	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $53.70 / $83.18	Professional		$42.66	$53.70	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $154.88	Professional		$89.13	$120.23	$154.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $70.79 / $181.97	Professional		$45.71	$70.79	$181.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $74.13 / $162.18	Facility		$44.67	$74.13	$162.18
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $426.58	Professional		$70.79	$109.65	$426.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $147.91	Professional		$77.62	$107.15	$147.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $100.00	Professional		$79.43	$100.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $77.62 / $138.04	Professional		$60.26	$77.62	$138.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $95.50	Professional		$64.57	$75.86	$95.50