Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $102.33	Facility		$85.11	$85.11	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $77.62 / $117.49	Professional		$53.70	$77.62	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $177.83	Facility		$91.20	$91.20	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $158.49 / $199.53	Professional		$91.20	$158.49	$199.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $13.80 / $14.13	Professional		$11.22	$13.80	$14.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $208.93 / $645.65	Facility		$19.95	$208.93	$645.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $79.43 / $177.83	Professional		$63.10	$79.43	$177.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $199.53 / $407.38	Professional		$173.78	$199.53	$407.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $7.08 / $57.54 / $112.20	Facility		$7.08	$57.54	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $77.62 / $194.98	Professional		$70.79	$77.62	$194.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $141.25	Professional		$112.20	$141.25	$141.25