Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $245.47 / $501.19	Facility		$22.91	$245.47	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $269.15 / $660.69	Professional		$154.88	$269.15	$660.69
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $229.09 / $398.11 / $831.76	Professional	25	$229.09	$398.11	$831.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $426.58 / $645.65	Professional		$309.03	$426.58	$645.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $257.04 / $512.86	Professional		$154.88	$257.04	$512.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $275.42 / $562.34	Facility		$169.82	$275.42	$562.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $380.19 / $1,202.26	Professional		$251.19	$380.19	$1,202.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $660.69	Professional		$275.42	$426.58	$660.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $398.11 / $407.38	Professional		$338.84	$398.11	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $331.13 / $416.87	Facility		$190.55	$331.13	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $269.15 / $478.63	Professional		$173.78	$269.15	$478.63
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $275.42 / $398.11	Professional		$229.09	$275.42	$398.11