Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $41.69 / $87.10	Facility		$30.90	$41.69	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $41.69 / $89.13	Professional		$28.18	$41.69	$89.13
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $37.15 / $37.15 / $51.29	Professional	25	$37.15	$37.15	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $112.20	Professional		$69.18	$87.10	$112.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $46.77 / $104.71	Professional		$28.18	$46.77	$104.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $43.65 / $154.88	Facility		$28.18	$43.65	$154.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $69.18 / $302.00	Professional		$39.81	$69.18	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $69.18 / $125.89	Professional		$48.98	$69.18	$125.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $43.65 / $75.86	Professional		$30.20	$43.65	$75.86
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $50.12 / $67.61	Professional		$40.74	$50.12	$67.61