Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $54.95 / $114.82	Facility		$44.67	$54.95	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $54.95 / $95.50	Professional		$34.67	$54.95	$95.50
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $42.66 / $54.95 / $67.61	Professional	25	$42.66	$54.95	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $144.54	Professional		$72.44	$114.82	$144.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $63.10 / $125.89	Professional		$40.74	$63.10	$125.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $72.44 / $223.87	Facility		$41.69	$72.44	$223.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $77.62 / $316.23	Professional		$43.65	$77.62	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $165.96	Professional		$72.44	$100.00	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Professional		$91.20	$91.20	$91.20
United Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $257.04 / $316.23	Facility		$147.91	$257.04	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $83.18	Professional		$33.88	$47.86	$83.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $70.79 / $89.13	Professional		$58.88	$70.79	$89.13