Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.47 / $155.47 / $178.76	Facility		$155.47	$155.47	$178.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.21 / $145.86 / $214.72	Professional		$107.21	$145.86	$214.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.95 / $147.10 / $147.10	Facility		$28.95	$147.10	$147.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.38 / $255.00 / $971.59	Professional		$107.38	$255.00	$971.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $24.68 / $52.65 / $60.13	Professional		$24.68	$52.65	$60.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.79 / $80.00 / $761.52	Facility		$31.79	$80.00	$761.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.26 / $17.47 / $80.44	Professional		$12.26	$17.47	$80.44
Midlands Facility/Professional Facility Modifier Low / Median / High Price $34.03 / $34.03 / $80.44	Facility		$34.03	$34.03	$80.44
Midlands Facility/Professional Professional Modifier Low / Median / High Price $33.79 / $40.70 / $80.44	Professional		$33.79	$40.70	$80.44
United Facility/Professional Professional Modifier Low / Median / High Price $12.26 / $14.40 / $29.97	Professional		$12.26	$14.40	$29.97
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $332.61 / $332.61 / $332.61	Facility		$332.61	$332.61	$332.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $262.76 / $332.61 / $332.61	Professional		$262.76	$332.61	$332.61