Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.80 / $81.80 / $91.37	Facility		$81.80	$81.80	$91.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.27 / $73.75 / $84.05	Professional		$59.27	$73.75	$84.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.40 / $152.10 / $192.41	Professional		$101.40	$152.10	$192.41
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $63.74 / $90.13 / $173.58	Professional		$63.74	$90.13	$173.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.03 / $100.98 / $168.87	Facility		$64.03	$100.98	$168.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.21 / $138.60 / $462.92	Professional		$90.21	$138.60	$462.92
Midlands Facility/Professional Facility Modifier Low / Median / High Price $100.98 / $140.53 / $168.87	Facility		$100.98	$140.53	$168.87
Midlands Facility/Professional Professional Modifier Low / Median / High Price $101.40 / $146.11 / $186.72	Professional		$101.40	$146.11	$186.72
United Facility/Professional Professional Modifier Low / Median / High Price $84.89 / $102.56 / $190.43	Professional		$84.89	$102.56	$190.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $89.70 / $105.50 / $118.30	Professional		$89.70	$105.50	$118.30