Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $22.91 / $28.84	Professional		$18.20	$22.91	$28.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $58.88 / $151.36	Professional		$54.95	$58.88	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $22.91 / $50.12	Facility		$19.95	$22.91	$50.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $9.33 / $22.91	Professional		$9.33	$9.33	$22.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $9.33 / $9.33	Professional		$9.33	$9.33	$9.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $22.91 / $22.91	Professional		$9.33	$22.91	$22.91
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.30 / $26.30	Professional		$26.30	$26.30	$26.30
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $7.76 / $7.76	Professional		$7.76	$7.76	$7.76