Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $61.66	Professional		$32.36	$47.86	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $83.18 / $97.72	Professional		$52.48	$83.18	$97.72
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $109.65 / $151.36	Professional		$93.33	$109.65	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $74.13 / $165.96	Facility		$54.95	$74.13	$165.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $51.29 / $165.96	Professional		$38.90	$51.29	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $83.18 / $165.96	Professional		$52.48	$83.18	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $151.36	Professional		$72.44	$109.65	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $47.86	Facility		$42.66	$42.66	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $42.66 / $70.79	Professional		$38.02	$42.66	$70.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86