Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.02 / $42.66	Professional		$33.11	$38.02	$42.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $69.18 / $114.82	Facility		$47.86	$69.18	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $69.18 / $281.84	Professional		$40.74	$69.18	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $89.13	Professional		$63.10	$69.18	$89.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33