Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.36 / $86.36 / $106.34	Facility		$86.36	$86.36	$106.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.77 / $70.94 / $121.03	Professional		$44.77	$70.94	$121.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $62.10 / $160.78	Facility		$62.10	$62.10	$160.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $160.78 / $208.59	Professional		$62.10	$160.78	$208.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $15.46 / $16.23	Professional		$13.80	$15.46	$16.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.01 / $169.85 / $640.17	Facility		$40.01	$169.85	$640.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.53 / $72.92 / $191.06	Professional		$52.53	$72.92	$191.06
Midlands Facility/Professional Facility Modifier Low / Median / High Price $17.86 / $17.86 / $42.22	Facility		$17.86	$17.86	$42.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $17.80 / $21.41 / $42.22	Professional		$17.80	$21.41	$42.22
United Facility/Professional Professional Modifier Low / Median / High Price $60.68 / $72.92 / $191.06	Professional		$60.68	$72.92	$191.06
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $103.92 / $131.54 / $131.54	Professional		$103.92	$131.54	$131.54