Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $154.88 / $169.82	Facility		$75.86	$154.88	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $72.44 / $97.72	Professional		$60.26	$72.44	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.88 / $194.98	Professional		$112.20	$154.88	$194.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $218.78	Professional		$61.66	$85.11	$218.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $93.33 / $338.84	Facility		$63.10	$93.33	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $141.25 / $512.86	Professional		$87.10	$141.25	$512.86
Midlands Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $194.98	Professional		$100.00	$138.04	$194.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $100.00 / $173.78	Professional		$77.62	$100.00	$173.78
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $100.00 / $117.49	Professional		$89.13	$100.00	$117.49