Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $134.90	Facility		$97.72	$97.72	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $97.72 / $141.25	Professional		$79.43	$97.72	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $177.83	Facility		$97.72	$97.72	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $186.21 / $234.42	Professional		$97.72	$186.21	$234.42
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.85 / $15.85	Professional		$12.88	$15.85	$15.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $323.59 / $758.58	Facility		$17.78	$323.59	$758.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $93.33 / $208.93	Professional		$72.44	$93.33	$208.93
Midlands Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $208.93 / $208.93	Professional		$177.83	$208.93	$208.93
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 $7.94 / $64.57 / $123.03	Facility		$7.94	$64.57	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $257.04	Professional		$79.43	$93.33	$257.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $144.54 / $144.54	Professional		$114.82	$144.54	$144.54