Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.00 / $112.00 / $134.93	Facility		$112.00	$112.00	$134.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.40 / $100.11 / $154.66	Professional		$77.40	$100.11	$154.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.30 / $120.30 / $236.68	Facility		$120.30	$120.30	$236.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.30 / $196.50 / $245.63	Professional		$120.30	$196.50	$245.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $16.10 / $17.19 / $30.68	Professional		$16.10	$17.19	$30.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $269.49 / $812.03	Facility		$27.54	$269.49	$812.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.40 / $105.14 / $253.40	Professional		$77.40	$105.14	$253.40
Midlands Facility/Professional Facility Modifier Low / Median / High Price $23.67 / $23.67 / $55.95	Facility		$23.67	$23.67	$55.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $29.24 / $55.95	Professional		$23.50	$29.24	$55.95
United Facility/Professional Professional Modifier Low / Median / High Price $92.53 / $92.53 / $253.40	Professional		$92.53	$92.53	$253.40
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $193.64 / $193.64 / $193.64	Facility		$193.64	$193.64	$193.64
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $152.97 / $193.64 / $193.64	Professional		$152.97	$193.64	$193.64