Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $223.87 / $223.87	Facility		$169.82	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $234.42	Professional		$114.82	$169.82	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $302.00	Facility		$177.83	$177.83	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $309.03 / $389.05	Professional		$181.97	$309.03	$389.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $295.12 / $316.23	Professional		$251.19	$295.12	$316.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $295.12 / $1,258.93	Facility		$181.97	$295.12	$1,258.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $457.09	Professional		$128.82	$190.55	$457.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $302.00 / $363.08	Professional		$295.12	$302.00	$363.08
Midlands Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $446.68 / $446.68	Professional		$275.42	$446.68	$446.68
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $177.83 / $204.17	Facility		$100.00	$177.83	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $131.83 / $245.47	Professional		$123.03	$131.83	$245.47
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $263.03 / $263.03	Professional		$204.17	$263.03	$263.03