Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $450.00 / $450.00 / $495.00	Professional		$450.00	$450.00	$495.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.18 / $741.00 / $926.25	Professional		$216.18	$741.00	$926.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $275.00	Professional		$150.00	$150.00	$275.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $221.05 / $450.00 / $742.50	Facility		$221.05	$450.00	$742.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $188.16 / $216.18 / $216.18	Professional		$188.16	$216.18	$216.18
Midlands Facility/Professional Facility Modifier Low / Median / High Price $207.20 / $216.18 / $216.18	Facility		$207.20	$216.18	$216.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $188.16 / $201.62 / $216.18	Professional		$188.16	$201.62	$216.18
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $180.00 / $180.00 / $180.00	Facility		$180.00	$180.00	$180.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $142.19 / $180.00 / $180.00	Professional		$142.19	$180.00	$180.00