Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.51 / $101.51 / $122.22	Facility		$101.51	$101.51	$122.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.60 / $92.44 / $140.16	Professional		$55.60	$92.44	$140.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.50 / $111.50 / $199.68	Facility		$111.50	$111.50	$199.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.50 / $193.50 / $241.88	Professional		$111.50	$193.50	$241.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $16.68 / $17.30	Professional		$15.85	$16.68	$17.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.22 / $242.57 / $782.12	Facility		$47.22	$242.57	$782.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.69 / $94.47 / $229.52	Professional		$75.69	$94.47	$229.52
Midlands Facility/Professional Facility Modifier Low / Median / High Price $19.98 / $19.98 / $47.22	Facility		$19.98	$19.98	$47.22
Midlands Facility/Professional Professional Modifier Low / Median / High Price $19.85 / $23.91 / $47.22	Professional		$19.85	$23.91	$47.22
United Facility/Professional Professional Modifier Low / Median / High Price $80.23 / $88.70 / $229.52	Professional		$80.23	$88.70	$229.52
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $129.07 / $163.38 / $163.38	Professional		$129.07	$163.38	$163.38