Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.22 / $129.22 / $155.62	Facility		$129.22	$129.22	$155.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.31 / $113.08 / $176.51	Professional		$76.31	$113.08	$176.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.68 / $130.68 / $253.52	Facility		$130.68	$130.68	$253.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.68 / $241.50 / $315.93	Professional		$130.68	$241.50	$315.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $16.70 / $20.83 / $20.88	Professional		$16.70	$20.83	$20.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.48 / $267.10 / $937.40	Facility		$29.48	$267.10	$937.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $112.51 / $292.24	Professional		$79.48	$112.51	$292.24
Midlands Facility/Professional Facility Modifier Low / Median / High Price $24.84 / $25.36 / $59.93	Facility		$24.84	$25.36	$59.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $24.65 / $29.69 / $59.93	Professional		$24.65	$29.69	$59.93
United Facility/Professional Professional Modifier Low / Median / High Price $95.39 / $112.51 / $292.24	Professional		$95.39	$112.51	$292.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $163.86 / $207.42 / $207.42	Professional		$163.86	$207.42	$207.42