Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $72.44	Facility		$57.54	$57.54	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $52.48 / $79.43	Professional		$38.90	$52.48	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $114.82	Facility		$60.26	$60.26	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $109.65 / $138.04	Professional		$60.26	$109.65	$138.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $9.33 / $9.33	Professional		$7.59	$9.33	$9.33
Medica Facility/Professional Facility Modifier Low / Median / High Price $11.22 / $141.25 / $436.52	Facility		$11.22	$141.25	$436.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $54.95 / $117.49	Professional		$44.67	$54.95	$117.49
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $269.15	Professional		$112.20	$131.83	$269.15
Midlands Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
United Facility/Professional Facility Modifier Low / Median / High Price $4.90 / $41.69 / $75.86	Facility		$4.90	$41.69	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $51.29 / $131.83	Professional		$47.86	$51.29	$131.83
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $93.33	Professional		$74.13	$93.33	$93.33