Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $71.12	Professional		$20.00	$20.00	$71.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.85 / $252.33 / $353.12	Professional		$52.85	$252.33	$353.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $136.13 / $173.42 / $277.67	Professional		$136.13	$173.42	$277.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $31.00 / $295.97	Facility		$20.00	$31.00	$295.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.85 / $252.33 / $515.64	Professional		$52.85	$252.33	$515.64
Midlands Facility/Professional Facility Modifier Low / Median / High Price $52.85 / $52.85 / $52.85	Facility		$52.85	$52.85	$52.85
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.85 / $52.85 / $252.33	Professional		$52.85	$52.85	$252.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $234.00 / $296.20 / $296.20	Professional		$234.00	$296.20	$296.20