Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.91 / $112.91 / $136.00	Facility		$112.91	$112.91	$136.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.50 / $101.35 / $155.93	Professional		$69.50	$101.35	$155.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.51 / $115.51 / $229.30	Facility		$115.51	$115.51	$229.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.51 / $205.50 / $256.88	Professional		$115.51	$205.50	$256.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $16.55 / $17.42 / $17.71	Professional		$16.55	$17.42	$17.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.18 / $284.38 / $829.11	Facility		$54.18	$284.38	$829.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.74 / $109.30 / $267.17	Professional		$86.74	$109.30	$267.17
Midlands Facility/Professional Facility Modifier Low / Median / High Price $22.92 / $22.92 / $54.18	Facility		$22.92	$22.92	$54.18
Midlands Facility/Professional Professional Modifier Low / Median / High Price $22.77 / $27.41 / $54.18	Professional		$22.77	$27.41	$54.18
United Facility/Professional Professional Modifier Low / Median / High Price $93.26 / $101.19 / $255.40	Professional		$93.26	$101.19	$255.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $148.21 / $187.61 / $187.61	Professional		$148.21	$187.61	$187.61