Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Facility		$141.25	$141.25	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $147.91 / $151.36	Professional		$141.25	$147.91	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $245.47 / $302.00	Facility		$190.55	$245.47	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $151.36 / $181.97	Professional		$147.91	$151.36	$181.97
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $275.42	Professional		$151.36	$199.53	$275.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $177.83 / $331.13	Facility		$134.90	$177.83	$331.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $281.84	Professional		$162.18	$162.18	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $213.80	Professional		$134.90	$134.90	$213.80
Midlands Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $257.04 / $302.00	Facility		$204.17	$257.04	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $0.16 / $147.91 / $162.18	Facility		$0.16	$147.91	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $162.18	Professional		$125.89	$162.18	$162.18
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18