Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $144.54 / $144.54	Facility		$95.50	$144.54	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $87.10 / $144.54	Professional		$67.61	$87.10	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $213.80	Facility		$95.50	$95.50	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $158.49 / $194.98	Professional		$95.50	$158.49	$194.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $13.49 / $151.36	Professional		$12.59	$13.49	$151.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $223.87 / $645.65	Facility		$21.38	$223.87	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $97.72 / $218.78	Professional		$40.74	$97.72	$218.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $489.78	Professional		$208.93	$245.47	$489.78
Midlands Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Facility		$213.80	$213.80	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $67.61 / $117.49	Facility		$8.13	$67.61	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $93.33 / $213.80	Professional		$77.62	$93.33	$213.80
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $169.82	Professional		$134.90	$169.82	$169.82