Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $151.36 / $186.21	Facility		$75.86	$151.36	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $83.18 / $123.03	Professional		$67.61	$83.18	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $234.42	Professional		$141.25	$186.21	$234.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $223.87	Professional		$72.44	$107.15	$223.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $123.03 / $245.47	Facility		$75.86	$123.03	$245.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $630.96	Professional		$107.15	$162.18	$630.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $218.78	Professional		$123.03	$169.82	$218.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $147.91	Professional		$125.89	$147.91	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $120.23 / $204.17	Professional		$91.20	$120.23	$204.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $120.23 / $144.54	Professional		$102.33	$120.23	$144.54