Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.57 / $93.57 / $106.76	Facility		$93.57	$93.57	$106.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.07 / $93.14 / $123.34	Professional		$43.07	$93.14	$123.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.15 / $88.15 / $161.40	Facility		$88.15	$88.15	$161.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.79 / $161.40 / $212.81	Professional		$90.79	$161.40	$212.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $146.72 / $186.20 / $211.20	Professional		$146.72	$186.20	$211.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.29 / $170.51 / $689.27	Facility		$100.29	$170.51	$689.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $75.65 / $200.49	Professional		$62.23	$75.65	$200.49
Midlands Facility/Professional Facility Modifier Low / Median / High Price $160.94 / $161.40 / $193.44	Facility		$160.94	$161.40	$193.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $126.33 / $182.89 / $308.44	Professional		$126.33	$182.89	$308.44
United Facility/Professional Facility Modifier Low / Median / High Price $49.35 / $82.22 / $97.64	Facility		$49.35	$82.22	$97.64
United Facility/Professional Professional Modifier Low / Median / High Price $62.23 / $73.20 / $190.75	Professional		$62.23	$73.20	$190.75
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $139.38 / $139.38 / $139.38	Facility		$139.38	$139.38	$139.38
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $110.12 / $139.38 / $139.38	Professional		$110.12	$139.38	$139.38