Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $126.11 / $149.50	Professional		$98.27	$126.11	$149.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $310.70 / $357.50	Professional		$150.00	$310.70	$357.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $127.50 / $144.94	Facility		$75.00	$127.50	$144.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.48 / $126.11 / $126.11	Professional		$109.48	$126.11	$126.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $126.11 / $126.11 / $126.11	Facility		$126.11	$126.11	$126.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $109.48 / $126.11 / $126.11	Professional		$109.48	$126.11	$126.11
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $105.00 / $105.00	Facility		$105.00	$105.00	$105.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $82.95 / $105.00 / $105.00	Professional		$82.95	$105.00	$105.00