Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Facility		$30.00	$30.00	$30.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $60.00	Facility		$45.00	$45.00	$60.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.80 / $52.39 / $76.59	Professional		$21.80	$52.39	$76.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $66.78 / $142.46	Professional		$45.00	$66.78	$142.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $270.00 / $270.00	Facility		$30.00	$270.00	$270.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $95.00	Professional		$45.00	$45.00	$95.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $76.59 / $76.59 / $76.59	Facility		$76.59	$76.59	$76.59
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.84 / $66.84 / $71.63	Professional		$66.84	$66.84	$71.63
United Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $70.70 / $70.70	Professional		$70.70	$70.70	$70.70