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 Professional Modifier Low / Median / High Price $10.99 / $19.32 / $96.82	Professional		$10.99	$19.32	$96.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $34.06 / $36.43	Professional		$33.11	$34.06	$36.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $51.00 / $90.00	Facility		$30.00	$51.00	$90.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.49 / $108.59	Professional		$12.49	$12.49	$108.59
Midlands Facility/Professional Facility Modifier Low / Median / High Price $12.49 / $12.49 / $78.29	Facility		$12.49	$12.49	$78.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $71.09 / $76.18	Professional		$12.49	$71.09	$76.18
United Facility/Professional Professional Modifier Low / Median / High Price $108.59 / $108.59 / $108.59	Professional		$108.59	$108.59	$108.59
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $10.40 / $10.40 / $10.40	Facility		$10.40	$10.40	$10.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $8.22 / $10.40 / $10.40	Professional		$8.22	$10.40	$10.40