Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.80 / $28.80 / $34.52	Facility		$28.80	$28.80	$34.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.41 / $26.06 / $39.58	Professional		$17.41	$26.06	$39.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.99 / $29.99 / $58.03	Facility		$29.99	$29.99	$58.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.99 / $52.88 / $67.39	Professional		$29.99	$52.88	$67.39
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $4.32 / $4.57 / $4.62	Professional		$4.32	$4.57	$4.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.70 / $74.58 / $215.23	Facility		$13.70	$74.58	$215.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.43 / $25.75 / $64.81	Professional		$20.43	$25.75	$64.81
Midlands Facility/Professional Facility Modifier Low / Median / High Price $5.80 / $5.80 / $13.70	Facility		$5.80	$5.80	$13.70
Midlands Facility/Professional Professional Modifier Low / Median / High Price $5.75 / $6.93 / $13.70	Professional		$5.75	$6.93	$13.70
United Facility/Professional Facility Modifier Low / Median / High Price $2.10 / $18.20 / $37.39	Facility		$2.10	$18.20	$37.39
United Facility/Professional Professional Modifier Low / Median / High Price $22.60 / $25.75 / $64.81	Professional		$22.60	$25.75	$64.81
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $37.51 / $47.48 / $47.48	Professional		$37.51	$47.48	$47.48