Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $320.61 / $320.61 / $383.25	Facility		$320.61	$320.61	$383.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.72 / $281.23 / $451.97	Professional		$186.72	$281.23	$451.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $235.00 / $238.50 / $472.67	Facility		$235.00	$238.50	$472.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.00 / $615.00 / $768.75	Professional		$235.00	$615.00	$768.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $51.95 / $51.95 / $450.18	Professional		$51.95	$51.95	$450.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.45 / $606.70 / $2,575.35	Facility		$63.45	$606.70	$2,575.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $154.57 / $209.20 / $588.11	Professional		$154.57	$209.20	$588.11
Midlands Facility/Professional Facility Modifier Low / Median / High Price $63.45 / $63.45 / $149.97	Facility		$63.45	$63.45	$149.97
Midlands Facility/Professional Professional Modifier Low / Median / High Price $62.98 / $75.83 / $149.97	Professional		$62.98	$75.83	$149.97
United Facility/Professional Facility Modifier Low / Median / High Price $26.05 / $170.10 / $269.45	Facility		$26.05	$170.10	$269.45
United Facility/Professional Professional Modifier Low / Median / High Price $154.57 / $198.82 / $423.30	Professional		$154.57	$198.82	$423.30
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $410.10 / $519.12 / $519.12	Professional		$410.10	$519.12	$519.12