Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.98 / $105.98 / $127.65	Facility		$105.98	$105.98	$127.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.77 / $97.36 / $146.35	Professional		$65.77	$97.36	$146.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.90 / $115.90 / $217.46	Facility		$115.90	$115.90	$217.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.90 / $192.00 / $245.20	Professional		$115.90	$192.00	$245.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $13.73 / $16.82 / $17.16	Professional		$13.73	$16.82	$17.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.30 / $229.13 / $782.36	Facility		$25.30	$229.13	$782.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.16 / $96.55 / $239.71	Professional		$70.16	$96.55	$239.71
Midlands Facility/Professional Facility Modifier Low / Median / High Price $21.75 / $21.75 / $51.40	Facility		$21.75	$21.75	$51.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $21.59 / $26.00 / $51.40	Professional		$21.59	$26.00	$51.40
United Facility/Professional Professional Modifier Low / Median / High Price $86.93 / $87.53 / $239.71	Professional		$86.93	$87.53	$239.71
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $140.56 / $177.92 / $177.92	Professional		$140.56	$177.92	$177.92