Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.66 / $56.66 / $64.64	Facility		$56.66	$56.66	$64.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.61 / $56.26 / $74.69	Professional		$27.61	$56.26	$74.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.47 / $59.47 / $97.74	Facility		$59.47	$59.47	$97.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.47 / $98.69 / $128.91	Professional		$59.47	$98.69	$128.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $86.61 / $88.85 / $113.22	Professional		$86.61	$88.85	$113.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.71 / $114.17 / $415.82	Facility		$60.71	$114.17	$415.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.47 / $63.26 / $121.38	Professional		$42.47	$63.26	$121.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $97.46 / $97.74 / $121.48	Facility		$97.46	$97.74	$121.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $80.03 / $114.17 / $186.75	Professional		$80.03	$114.17	$186.75
United Facility/Professional Professional Modifier Low / Median / High Price $42.47 / $44.32 / $110.14	Professional		$42.47	$44.32	$110.14
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $87.07 / $87.07 / $87.07	Facility		$87.07	$87.07	$87.07
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $68.79 / $87.07 / $87.07	Professional		$68.79	$87.07	$87.07