Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $60.00 / $60.00	Facility		$60.00	$60.00	$60.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $60.00	Professional		$60.00	$60.00	$60.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $125.00	Facility		$90.00	$90.00	$125.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.51 / $125.15 / $158.16	Professional		$54.51	$125.15	$158.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $133.56 / $197.77	Professional		$90.00	$133.56	$197.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $260.00 / $260.00	Facility		$60.00	$260.00	$260.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $170.00	Professional		$85.00	$85.00	$170.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $158.16 / $158.16 / $158.16	Facility		$158.16	$158.16	$158.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $138.05 / $138.05 / $147.93	Professional		$138.05	$138.05	$147.93
United Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $85.00 / $85.00	Professional		$85.00	$85.00	$85.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $147.40 / $147.40 / $147.40	Professional		$147.40	$147.40	$147.40