Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.36 / $111.36 / $133.44	Facility		$111.36	$111.36	$133.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.61 / $100.92 / $153.01	Professional		$68.61	$100.92	$153.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.47 / $114.47 / $225.49	Facility		$114.47	$114.47	$225.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.47 / $202.50 / $258.50	Professional		$114.47	$202.50	$258.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $17.59 / $18.30	Professional		$16.60	$17.59	$18.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.33 / $272.69 / $821.01	Facility		$53.33	$272.69	$821.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.07 / $107.91 / $250.60	Professional		$87.07	$107.91	$250.60
Midlands Facility/Professional Facility Modifier Low / Median / High Price $22.56 / $22.56 / $53.33	Facility		$22.56	$22.56	$53.33
Midlands Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $26.96 / $53.33	Professional		$22.39	$26.96	$53.33
United Facility/Professional Professional Modifier Low / Median / High Price $91.51 / $107.91 / $259.72	Professional		$91.51	$107.91	$259.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $145.75 / $184.49 / $184.49	Professional		$145.75	$184.49	$184.49