Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $512.86 / $630.96	Professional		$141.25	$512.86	$630.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $363.08 / $416.87	Professional		$275.42	$363.08	$416.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $52.48 / $134.90	Facility		$39.81	$52.48	$134.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $102.33 / $117.49	Professional		$100.00	$102.33	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $117.49	Professional		$102.33	$102.33	$117.49
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72