Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $162.18	Professional		$97.72	$123.03	$162.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $562.34 / $602.56	Professional		$426.58	$562.34	$602.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $257.04 / $707.95	Facility		$144.54	$257.04	$707.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $891.25	Professional		$194.98	$288.40	$891.25
Midlands Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $257.04 / $302.00	Professional		$173.78	$257.04	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $302.00 / $398.11	Professional		$288.40	$302.00	$398.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19