Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.58 / $88.58 / $106.67	Facility		$88.58	$88.58	$106.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.88 / $80.48 / $122.33	Professional		$50.88	$80.48	$122.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.65 / $94.65 / $178.01	Facility		$94.65	$94.65	$178.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.65 / $165.75 / $211.63	Professional		$94.65	$165.75	$211.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $13.59 / $14.42 / $14.44	Professional		$13.59	$14.42	$14.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.09 / $221.97 / $679.35	Facility		$42.09	$221.97	$679.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.27 / $81.86 / $200.32	Professional		$69.27	$81.86	$200.32
Midlands Facility/Professional Facility Modifier Low / Median / High Price $17.80 / $17.80 / $42.09	Facility		$17.80	$17.80	$42.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $17.66 / $21.28 / $42.09	Professional		$17.66	$21.28	$42.09
United Facility/Professional Professional Modifier Low / Median / High Price $70.58 / $80.02 / $200.32	Professional		$70.58	$80.02	$200.32
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $115.06 / $145.65 / $145.65	Professional		$115.06	$145.65	$145.65